Options in the management of perforations of the esophagus

Brewer, Lyman A.; Carter, Richard; Mulder, G.Arnold; Stiles, Quentin R.

doi:10.1016/0002-9610(86)90144-3

Cited by 114 publications

(52 citation statements)

References 14 publications

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“…For this reason, during the nineties the rule proposed by Brewer et al (38) that the longer the delay in diagnosis, the more aggressive and extensive surgical treatment should be. Such a radical approach has been supported to this day by Kollmar et al, (14), Marinis (5), Tsalis (22), de Schipper (2) and Brauer (35) suggesting that primary repair of the damage should be reserved to early cases (12-24 h).…”

Section: Oesophagectomymentioning

confidence: 99%

Boerhaave’s Syndrome – Over 290 Yrs of Surgical Experiences. Surgical, Endoscopic and Conservative Treatment

Rokicki¹,

Rokicki²,

Rydel³

2016

Polish Journal of Surgery

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Section: Oesophagectomymentioning

confidence: 99%

Boerhaave’s Syndrome – Over 290 Yrs of Surgical Experiences. Surgical, Endoscopic and Conservative Treatment

Rokicki¹,

Rokicki²,

Rydel³

2016

Polish Journal of Surgery

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“…Conservative treatment has been advocated in case of small and early recognized perforations with well contained leak without signs of septicemia [4,5,28,29]. It consists of total prohibition of oral intake for a minimum of 7 days, administration of combination of broadspectrum antibiotics, use of prokinetic drugs (cisapride and metoclopramide), and feeding with a nasogastric tube or jejunostomy [4].…”

Section: Discussionmentioning

confidence: 99%

“…Cervical esophagus perforations are considered to be less critical than intrathoracic and intra-abdominal ones due to slow formation of descending mediastinitis [3][4][5], but they may be still fatal in up to 16% of cases [3].…”

Section: Introductionmentioning

confidence: 99%

Esophagus perforation complicating anterior cervical spine surgery

Lü

Guo

2011

Eur Spine J

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Purpose To study the diagnosis and treatment strategy of esophagus perforation complicating anterior cervical spine surgery.Methods From 2000 to 2010, we performed 1,045 cases of anterior cervical surgeries. One developed esophagus perforation. The diagnosis and treatment strategy of this case and the other five patients with esophagus perforation from other hospitals were retrospectively reviewed. For an intraoperative perforation, primary double layer suture was performed. Postoperatively, the patient took nutrition by a nasogastric tube instead of oral intake for one week. For three cases of perforations early in the post-operative period, oral intake was forbidden and nasogastric tube was conducted for nutrition support. The wound was debrided and open drainage was conducted postoperatively. Intravenous broad-spectrum antibiotic therapy was utilized. For perforations at postoperative year 3 and 7, prohibition of oral intake, intravenous broad-spectrum antibiotics therapy, and nasogastric tube nutrition support were all conducted and surgical debridement was performed. In operation, fixation plates and screws were removed, and the edges of the perforation were loosely approximated by synthetic absorbable sutures. Postoperatively, skin wound was kept open for drainage.Results All the perforations healed evenly without secondary complications. Conclusions When a perforation is suspected, imaging techniques should be employed. Surgical treatment facilitates the healing of esophagus perforation. Supportive treatments including prohibition of oral intake, intravenous broad-spectrum antibiotic therapy, feeding with a nasogastric tube were mandatory parts of treatments.

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“…A variety of treatment options are available ranging from conservative medical therapy to radical oesophagectomy. Newer modalities with interventional endoscopy with or without placement of stents are more frequently being described [4].…”

Section: Introductionmentioning

confidence: 99%