SP6.2.2 Oesophageal Perforation: The Experience of a Tertiary Referral Centre 2009–2021

Abstract

Aim Oesophageal perforation is a relatively rare surgical condition associated with a high mortality risk. Currently there is no clear consensus on a superior approach to treating this condition, and the rarity of oesophageal perforation has led to a great variability in treatment between centres. This study aims to report the experiences of a tertiary referral centre over 12 years. Methods We collected data on patients presenting with oesophageal perforation at a tertiary referral centre from 2009–2021 (n=83). Demographics, presenting symptoms, length of stay and complications were collected retrospectively using the electronic patient record. Results The most common cause of perforation in our dataset was Boerhaave's (50.6%), followed by Iatrogenic (37.4%); other causes included trauma, malignancy and foreign body ingestion. Typical signs/symptoms included chest pain (54.2%), vomiting (48.2%), and pleural effusion (42.2%). For all aetiologies, operative intervention was required in 49.4% of patients. Patients presenting with Boerhaave's were more likely to be treated surgically (73.8%). Of these, thoracotomy/laparotomy with t-tube repair was the most common procedure performed (59.5%). The 30 day and 90 day mortality rates were 16.9% and 21.6% respectively. The median length of hospital stay was 40 days. Conclusion Here we show the experience from a high intake tertiary referral centre over 12 years. Our data confirms the severity of oesophageal perforation and its association with prolonged hospital stay and mortality. Further collaboration with other centres is needed to understand more about this condition.