Laparoscopic Treatment of Boerhaave Syndrome. Case Report

Semenyakin, I.V.; Луцевич, О. Э.; Галлямов, Э. А.; Shestakov, A. L.; Erin, S A; Дибиров, М. Д.; Kytirev, Evgeniy A.; BOBYLEV, A.; KOSYAKOV, N.; Фомин, В. С.; BOKAREV, F.; Gololobov, G Yu

doi:10.17238/issn2072-3180.2019.5.9-14

Cited by 2 publications

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“…Вместе с тем, хирургические приемы различны. Некоторые авторы сходятся в необходимости обычного ушивания дефекта пищевода [2, 6, 7] или с укреплением линии швов медиастинальной плеврой [1], фундопликационной манжетой [1,3,4,5,8,9], гемостатической губкой «тахокомб» [10]. В этих же работах описаны частые случаи несостоятельности швов [2, 5, 6, 10], либо стенозы возникающие позже [9].…”

Section: №1 (44) 2021unclassified

“…В целом считаем опыт использования видеоэндоскопических технологий в хирургическом лечении синдрома Бурхаве перспективным, что подтверждается наблюдением других авторов [8]. Предложенный доступ позволяет добиться адекватного дренажа даже в условиях крупного дефекта пищевода, гнойного медиастинита с эмпиемой плевры.…”

Section: №1 (44) 2021unclassified

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The Choice of Surgical Tactics for Boerhaave Syndrome in Combination With Bilateral Pleural Empyema (Clinical Case)

Ганков

Шестаков

Маншетов

et al. 2021

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Introduction. Boerhaave syndrome is a rare, difficult to diagnose and formidable disease with a high mortality rate. For the treatment of this pathology, many variants of interventions have been proposed. Some surgeons prefer to use a thoracotomic access, others – a laparotomic transhiatal one. In the domestic literature there are scant observations of usement of minimally invasive technologies.Clinical observation. The patient was admitted to the surgical department for emergency indications. In the admission department spontaneous left side hydropneumothorax was diagnosted. Drainage of the left pleural cavity was performed. On the second day, a spontaneous rupture of the esophagus was diagnosed. Video-laparotranschiatal drainage of the posterior mediastinum, drainage of the left subhepatic space, Maydl jejunostomy was performed. In the postoperative period, intensive conservative therapy was carried out, massive lavage of the mediastinum and the left pleural cavity with antiseptic solutions. For a long time, there was a large drainage debit. Because of treatment the dynamics were positive. On the 45th day the drainage of the pleural cavity was removed. By the 66th day complete healing of the esophageal defect and removal of the mediastinal drainage.Discussion. Due to the difficulties in diagnosis, a spontaneous rupture of the esophagus was detected a day later. The applied surgical access and technique allowed to provide adequate drainage and sanitation of the posterior mediastinum and left pleural cavity. The subsequent tactics of managing the patient ensured his recovery. The trauma of the video-laparotranschiatal access is less, in comparison with open surgical interventions. We consider the experience of using video endoscopic technologies for Boerhaave syndrome positive and promising.

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Section: №1 (44) 2021unclassified