Treatment for esophageal perforations: analysis of 11 cases

Arslan, Ersin; Şanlı, Maruf; Işık, Ahmet Feridun; Tunçözgür, Bülent; Ulusan, Ahmet; Elbeyli, Levent

doi:10.5505/tjtes.2011.41882

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Conservative treatments are advised in children whereas primary repair is the first choice in adults. [16] Except for two of our patients who underwent colon interposition, all perforations recovered with selective drainage procedures. Therefore, we suggest that following and applying the appropriate drainage procedure should be the first choice.…”

Section: Discussionmentioning

confidence: 72%

Our approach to esophageal perforation secondary to dilatation of caustic esophageal stricture in children

Soysal¹

2016

Turk Gogus Kalp Dama

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Bu çalışmada özofagus perforasyonu olan çocuklarda 20 yıllık deneyimimiz incelendi ve bir algoritma geliştirildi. Ça lış ma pla nı: Çalışmaya korozif özofajit darlığı nedeni ile Ocak 1985-Aralık 2014 tarihleri arasında kliniğimizde uygulanan dilatasyona bağlı özofagus perforasyonu gelişen 50 hasta (32 erkek, 18 kız; ort. yaş 4.7±2.6 yıl; dağılım 1-17 yıl) dahil edildi. Hastalar yaş, cinsiyet, korozif madde alımından başvuruya kadar geçen süre, dilatasyon işlemi sonrasında perforasyonun tanı almasına kadar geçen süre, klinik bulgular, perforasyonun yeri ve tedavi yöntemi açısından retrospektif olarak değerlendirildi. Bul gu lar: Perforasyon tanısı 40 hastada dilatasyondan sonraki 24 saat içinde, 10 hastada dilatasyondan 24 saat sonra konuldu. Daha geç tanı konulan hastalarda mortalite oranı daha yüksek idi (n=2). Perforasyonlar iki hastada servikal, dört hastada abdominal, 44 hastada torasik özofagusta idi. Yirmi bir hastada özofagus perforasyonu konservatif şekilde düzeldi ve cerrahi girişime gerek olmadı. Göğüs tüpü olan 29 hastadan 15'i konservatif tedavi ile düzelir iken dokuz hastaya torakotomi ile apse drenajı ve dekortikasyon, beş hastaya da özofagostomi ve gastrostomi uygulandı. Özofagostomi ve gastrostomi uygulanan beş hastadan ikisine kolon interpozisyon ameliyatı, üçüne gecikmiş anastomoz yapıldı. So nuç: Korozif özofajit darlığının dilatasyonuna bağlı özofagus perforasyonu hızlıca tanı konulması gereken ciddi bir sorundur ve tedavi yaklaşımı her hastanın durumuna göre bireyselleştirilmelidir.

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Section: Discussionmentioning

confidence: 72%

Our approach to esophageal perforation secondary to dilatation of caustic esophageal stricture in children

Soysal¹

2016

Turk Gogus Kalp Dama

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“…In most of the patients included in that study, surgical management was undertaken; primary closure was attempted in 19, and resection in 7; a conservative approach was taken in the other 10. Based on their findings, the researchers concluded that primary closure gives the most favorable result if attempted within 24 h. In a study by Arslan and colleagues, 19 with the aim of assessing the importance of surgical management of esophageal perforation, it was concluded that surgical management including primary repair when attempted within 72 h of perforation gives a satisfactory outcome. In their study, 11 patients were assessed between 2005 and 2010.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of esophageal perforation: role of primary closure

Vũ

Quang

Khôi

2019

Asian Cardiovasc Thorac Ann

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Objective Esophageal perforation is a life-threatening condition associated with high mortality and morbidity. Ambiguous clinical presentation is one of the most common causes of delayed and difficult diagnosis of esophageal perforation. In this retrospective single-center study, we reviewed the outcome of primary closure in patients with esophageal perforation between 2009 and 2017. Methods The data of 65 patients attending our department of thoracic surgery (from 2009 to 2017) for esophageal perforation were reviewed. Primary repair was attempted in 63 patients irrespective of the site of perforation and time interval between injury and hospital admission. In intrathoracic lesions, continuous mediastinal and pleural irrigation was undertaken, whereas in cervical perforations, gauze packing and local irrigation were performed. Jejunotomy was carried out in patients with inadequate healing. Results Of the 65 patients, 63 underwent primary closure and 2 were left to heal spontaneously. The majority of patients ( n = 44) had an esophageal perforation at the thoracic level, and only one was admitted early (<24 h after injury). Among the 63 patients managed with primary closure, 55 had satisfactory healing with one surgery. Healing was delayed in the other 10 patients. No mortality was reported. Conclusions Esophageal perforation can be well managed by primary closure, irrespective of the time interval between injury and hospital admission and the site of perforation. Conservative management might lead to an increased rate of complications such as empyema or necrotizing mediastinitis, and increased morbidity and mortality.

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