Omental wrapping of esophageal rupture in combination with T-tube drainage

Abstract

Esophageal rupture is a potentially fatal condition. Rapid and correct diagnosis and urgent surgical treatment are mandatory. Various surgical treatment methods have been reported. We introduced a new surgical procedure for treatment of spontaneous esophageal rupture. Upon thoracotomy continuing to laparotomy, a T-tube was inserted into the esophageal lumen through the ruptured site. The ruptured esophageal wall was sutured interruptedly, and the insertion site was covered with the pedicle omental flap. The T-tube was replaced by a thinner catheter tube from postoperative day (POD) 45 and finally withdrawn on POD 66. The patient was discharged in good condition on POD 98. The procedure described here is safe and effective. It is applicable for patients restricted to minimally invasive surgery, those with poor general condition and severely infectious contamination but without a widely necrotic esophageal wall around the ruptured site.

Pectoralis myocutaneous flap with T-tube drainage for cervical anastomotic leakage after salvage operation

“…Moreover, Ochiai et al reported a new and satisfactory procedure that involved wrapping a rupture of the lower thoracic esophagus with a pedicled omental flap in combination with T-tube drainage [12]. Esophageal leaks at sites The muscle pedicle exposed on the neck area was covered with splitthickness skin graft harvested from the thigh where it is difficult to achieve healing need continuous suction through the T-tube, in addition to wrapping with a well-vascularized muscle flap.…”

Esophageal ruptures: triage using the systemic inflammatory response syndrome score

“…Three patients (nos. 3,4,5) with positive SIRS without pleural effusion or empyema were treated only by drainage under general anesthesia. Five patients positive for SIRS with pleural effusion or empyema on admission underwent a one-stage operation, such as primary closure with tube drainage (patient 1) or two-staged operation such as open window thoracostomy at the fi rst stage operation followed by omental patch at second stage (nos.…”

Generation of Dithianyl and Dioxolanyl Radicals Using Photoredox Catalysis: Application in the Total Synthesis of the Danshenspiroketallactones via Radical Relay Chemistry

“…7 Completion of the total synthesis of danshenspiroketallactones 4 and 5 was then achieved via benzylic oxidation of the mixture of 14 and 15. Notably, by employing peroxide 16, 18 the α-alkoxy benzyl carbon could be chemoselectively oxidized in 80% yield, thus providing a mixture of danshenspiroketallactones 4 and 5. Separation of 4 and 5 via silica gel chromatography proved not possible, because epidanshenspiroketallactone 5 was found to undergo rapid isomerization to 4 on silica gel.…”