Esophageal emergencies: WSES guidelines

Chirica, Mircéa; Kelly, Michael D.; Siboni, Stefano; Aiolfi, Alberto; Riva, Carlo Galdino; Asti, Emanuele; Ferrari, Davide; Leppäniemi, Ari; Broek, Richard P. G. ten; Brichon, Pierre Yves; Kluger, Yoram; Fraga, Gustavo Pereira; Frey, Gil; Andreollo, Nelson Adami; Catena, Fausto; Frattini, Cristina; Moore, Ernest E.; Chiara, Osvaldo; Saverio, Salomone Di; Sartelli, Massimo; Weber, Dieter; Ansaloni, Luca; Biffl, Walter L.; Corté, Hélène; Wani, Iftikhar H; Baiocchi, Gian Luca; Cattan, Pierre; Catena, Fausto; Bonavina, Luigi

doi:10.1186/s13017-019-0245-2

Cited by 179 publications

(166 citation statements)

References 114 publications

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“…Iatrogenic perforation is the leading cause of esophageal perforations, accounting for around 60% of all cases. Less frequent causes are trauma at the upper abdomen or chest, Boerhaave's syndrome or spontaneous perforations induced by straining and vomiting 2 . Esophageal anastomotic leak remains one of the most devastating complications after esophagectomy and gastrectomy, with a wide range of reported incidences from 0 to 35% after esophagectomy and 2.7% to 12.3% after total gastrectomy 3 .The key point of a correct treatment includes resuscitation of the patient, assessment of the defect and timely decision-making 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Endoluminal Vacuum Assisted Closure (E-Vac) Therapy for Postoperative Esophageal Fistula: Successful Case Series and Literature Review

Rubicondo

Lovece

Pinelli

et al. 2020

Preprint

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Background: Treatment of esophageal perforations and postoperative anastomotic leaks of the upper gastrointestinal tract remains a challenge. Endoluminal vacuuma assisted closure (E-vac) therapy has positively contributed, in recent years, to the management of upper gastrointestinal tract perforations by using the same principle of vacuum assisted closure therapy of external wounds. The aim is to provide continuous wound drainage and to promote tissue granulation, decreasing the needed time to heal with a high rate of leakage closure.Report of cases: A series of two different cases with clinical and radiological diagnosis of esophageal fistulas, recorded during the 2018 to 2019 period at our institution, is presented. The first one is a case of anastomotic leak after esophagectomy for cancer complicated by pleuro-mediastinal abscess; while the second one is a leak of an esophageal suture, few days after resection of a bronchogenic cyst perforated into the esophageal lumen. Both cases were successfully treated with E-vac therapy.Conclusion: Our results confirm the usefulness of E-vac therapy in the management of anastomotic and non-anastomotic esophageal fistulas. Further research is needed to better define its indications, to compare it to traditional treatments and to evaluate its long-term efficacy.

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Section: Introductionmentioning

confidence: 99%

Endoluminal Vacuum Assisted Closure (E-Vac) Therapy for Postoperative Esophageal Fistula: Successful Case Series and Literature Review

Rubicondo

Lovece

Pinelli

et al. 2020

Preprint

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“…Oesophageal perforation is defined as transmural disruption of the oesophagus [1]. Possible causes include iatrogenic, spontaneous forceful rupture (Boerhaave's syndrome), malignancy and trauma.…”

Section: Introductionmentioning

confidence: 99%

Trans-hiatal repair for Oesophageal and Junctional perforation: a case series

et al. 2020

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Background: Oesophageal perforation is a life-threatening condition that requires urgent intervention. Surgical repair is recommended within 24 h of onset to minimise mortality risk, traditionally via an open thoracotomy or a laparotomy. Primary oesophageal repair via a laparoscopic trans-hiatal approach has been seldomly reported due to concerns of inadequate eradication of soilage in the mediastinum and pleural space, as well as poor access and an increased operative time in an unwell population. Case presentation: We report a case series of 3 oesophageal and junctional perforations with varying presentations, demonstrating how the laparoscopic trans-hiatal approach can be used successfully to manage oesophageal perforations. Conclusions: Laparoscopic trans-hiatal repair is an attractive option for oesophageal and junctional perforations, in haemodynamically stable surgical candidates, in the absence of gross contamination of the thoracic cavity.

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“…Spontaneous rupture of the esophagus (Boerhaave's syndrome, BS), rstly described in 1724, is de ned as the complete disruption of the esophageal wall, typically occurring after severe vomiting [1]. BS accounts for 15% of esophageal perforations, and the tear is usually located on the lower third of the esophagus [2]. Contrast esophagram and computed tomography (CT) are usually su cient for the diagnosis of BS.…”

Section: Introductionmentioning

confidence: 99%

Contralateral Spontaneous Rupture of the Esophagus Following severe Vomiting After Non-intubated Pulmonary Wedge Resection

Liu

Gong

et al. 2020

Preprint

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Background: Non-intubated thoracoscopic lung surgery has been widely applied as it is technically feasible and safe. Spontaneous rupture of the esophagus, also known as Boerhaave's syndrome (BS), is rare after chest surgery.Case Presentation: A 60-year-old female non-smoker underwent non-intubated uniportal thoracoscopic wedge resection assisted with a laryngeal mask for a solitary pulmonary nodule. Ultrasound-guided serratus anterior plane block was utilized for analgesia. The patient complained of hyperemesis followed by chest pain and acute dyspnea 6 hours after the surgery. Emergency chest x-ray revealed the right-sided hydropneumothorax. BS was confirmed by further chest tube drainage and computed tomography. The patient refused surgical intervention; therefore, conservative procedures including pleural evacuation through a naso-leakage drainage tube, antibiotics and tube feeding were administered. The healing of the esophagus was recorded 40 days later.Conclusions: Perioperative antiemetic is an indispensable item of tubeless thoracic surgery. BS should be kept in mind when the patients suffer from sudden chest distress following severe vomiting after tubeless lung surgery.

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Esophageal emergencies: WSES guidelines

Cited by 179 publications

References 114 publications

Endoluminal Vacuum Assisted Closure (E-Vac) Therapy for Postoperative Esophageal Fistula: Successful Case Series and Literature Review

Endoluminal Vacuum Assisted Closure (E-Vac) Therapy for Postoperative Esophageal Fistula: Successful Case Series and Literature Review

Trans-hiatal repair for Oesophageal and Junctional perforation: a case series

Contralateral Spontaneous Rupture of the Esophagus Following severe Vomiting After Non-intubated Pulmonary Wedge Resection

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