Treatment of spontaneous esophageal rupture (Boerhaave syndrome) using thoracoscopic surgery and sivelestat sodium hydrate

Okamoto, Hiroshi; Onodera, Ko; Kamba, Rikiya; Taniyama, Yusuke; Sakurai, Tadashi; Heishi, Takahiro; Teshima, Jin; Hikage, Makoto; Sato, Chiaki; Maruyama, Shota; Onodera, Yu; Ishida, Hirotaka; Kamei, Takashi

doi:10.21037/jtd.2018.03.136

Cited by 8 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 13 Minimally invasive techniques in specialised units (video assisted thoracoscopic surgery (VATS), thoracoscopy) can also be considered for haemodynamically stable patients as long as exposure of the injury can be satisfactory and manoeuvres allow for a safe repair. 14 , 15 Moreover, placement of a feeding jejunostomy allows for immediate enteral nutrition, although some authors have also reported the use of venting gastrostomy for safe decompression of the stomach in the treatment of spontaneous or iatrogenic oesophageal perforation in selected patients. 16 Intraoperative endoscopic management can also be combined with debridement and drainage of the mediastinum through VATS.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of Boerhaave syndrome in the past, present and future: updated results of a specialised surgical unit

Triantafyllou,

Lamb,

Skipworth

et al. 2024

annals

View full text Add to dashboard Cite

Introduction Boerhaave syndrome is a rare clinical entity associated with high rates of morbidity and mortality. Early recognition of the symptoms, and identification of the site and extension of the injury are key in improving the prognosis. Methods This study presents data on the mortality, morbidity and length of hospital stay in patients diagnosed with Boerhaave syndrome. The data were retrieved from a prospectively collected database in a single surgical unit between 2012 and 2022. The study makes a comparison with the surgical outcomes of the previous decade. Results Some 33 patients were diagnosed with Boerhaave syndrome and were treated surgically between 2012 and 2022 in a specialist upper gastrointestinal surgical unit. All patients underwent standard surgical repair (in-theatre diagnostic endoscopy, T-tube placement through thoracotomy and feeding jejunostomy through laparotomy). The mean size of the defects in the oesophageal lumen was 3.3cm. Delayed presentation was noted for 13 patients (39%); 8 patients (24%) died in hospital, and 19 patients (58%) developed postoperative complications. Mortality was similar to the rate recorded for the 20 patients from the previous decade (24% vs 20%, respectively). The mean length of hospital stay was 41 days, and was comparable to the 35.7 days reported between 1997 and 2011. Conclusions Early and aggressive management of spontaneous oesophageal rupture ameliorates the postoperative recovery and prognosis. The surgical results of our unit were found comparable to the previous decade in the population of patients who were treated surgically.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical treatment of Boerhaave syndrome in the past, present and future: updated results of a specialised surgical unit

Triantafyllou,

Lamb,

Skipworth

et al. 2024

annals

View full text Add to dashboard Cite

show abstract

“…The EGD is currently under discussion during the acute phase due to the risk of perforation worsening despite 100% sensitivity and 93% specificity. The treatment of this affection is based on two pillars (medical and surgery), and its effectiveness depends on the early diagnosis [15,16]. In case of early diagnosis and sepsis, surgery is preferred, whereas endoscopic approach is favored if the disease is diagnosed within 48 hours [17].…”

Section: Discussionmentioning

confidence: 99%

Atypical chest pain: A case report of Boerhaave syndrome

Margot¹,

Desmercieres²

2022

Int J Case Rep Images

View full text Add to dashboard Cite

The spontaneous rupture of the esophagus, commonly called Boerhaave syndrome, is a rare and serious disease with poor prognosis due to its diagnostic difficulty. The patients suffering from this condition need multidisciplinary technical platform, and the survival of patients correlates highly with early medical care with fluid resuscitation, antibiotics administration, and surgical care to treat the perforation using endoscopy or extrathoracic surgery. This article presents a case report of Boerhaave syndrome occurring in a Community Hospital and discusses the need for initial management and referral to University Hospital.

show abstract

“…Currently, BS and more generally esophageal perforations are considered as catastrophic conditions, often life-threatening, with 10 to 40% mortality rates (even higher rates are reported in septic patients with spontaneous perforations) [2]. Due to its very low incidence and aspecific features, more than 50% of cases are misdiagnosed, with a subsequent delay in treatment [3,4].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic transhiatal suture and gastric valve as a safe and feasible treatment for Boerhaave’s syndrome: an Italian single center case series study

et al. 2020

View full text Add to dashboard Cite

Background: Boerhaave's syndrome (BS) is a rare life-threating condition with poor prognosis. Unfortunately, due to its very low incidence, no clear evidences or definitive guidelines are currently available: in detail, surgical strategy is still a matter of debate. Most of the case series reports thoracic approach as the most widely used; conversely, transhiatal abdominal management is just described in sporadic case reports. In our center, the laparoscopic approach has been adopted for years: in the present study, we aim to show his feasibility by reporting the outcomes of the largest clinical series available to date. Methods: Clinical records of patients admitted for BS to the General and Upper GI Surgery Division of Verona from February 2014 to December 2019 were retrospectively collected. Clinico-pathological characteristics, preoperative workup, surgical management, and outcomes were analyzed. Results: Seven patients were admitted; epigastric/thoracic pain and vomiting were the most frequent symptoms at diagnosis. Laboratory findings were not specific; conversely, radiological imaging always revealed abnormal findings: particularly, CT had excellent sensitivity in detecting signs of esophageal perforation. All but one case had diagnostic workup and received surgery within 24 h. Every patient had laparoscopic transhiatal direct suture and gastric valve; 2 patients (28.6%) also needed a thoracoscopic toilette. Postoperative complications occurred in 4 patients (57%), but in only two of them (29%), the complication was severe according to Clavien-Dindo classification (both received thoracentesis or thoracic drainage for pleural effusion). Of note, no cases of postoperative esophageal leak were recorded. Postoperative mortality was 14% due to one patient who died for cardiovascular complications. Most of the patients (71.4%) were admitted to ICU after surgery (average length, 8.8 days); mean hospital stay was 14.7 days. No patients had readmissions.

show abstract

Treatment of spontaneous esophageal rupture (Boerhaave syndrome) using thoracoscopic surgery and sivelestat sodium hydrate

Abstract: Thoracoscopic surgery obtained acceptable results in all patients, including two with a significant time elapse from onset to treatment. Furthermore, sivelestat sodium hydrate was suggested to help improve postoperative respiration and inflammatory response.

Cited by 8 publications

References 26 publications

Surgical treatment of Boerhaave syndrome in the past, present and future: updated results of a specialised surgical unit

Surgical treatment of Boerhaave syndrome in the past, present and future: updated results of a specialised surgical unit

Atypical chest pain: A case report of Boerhaave syndrome

Laparoscopic transhiatal suture and gastric valve as a safe and feasible treatment for Boerhaave’s syndrome: an Italian single center case series study

Contact Info

Product

Resources

About