Treatment and outcomes of oesophageal perforation in a tertiary referral centre☆

Muir, Andrew D; White, Jennifer; McGuigan, Jim; McManus, Kieran; Graham, Alastair

doi:10.1016/s1010-7940(03)00050-2

Cited by 78 publications

(76 citation statements)

References 12 publications

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“…In these patients, a close surveillance with the option of both endoscopic and surgical treatment is critically important. Malignant disease has been shown to be associated with a worse outcome in patients treated with open surgery for esophageal leaks [19]. In our study, we did not see any differences in clinical outcome for endoscopically treated patients regardless of the underlying cause of the leak.…”

Section: Discussioncontrasting

confidence: 53%

Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent

et al. 2009

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Section: Discussioncontrasting

confidence: 53%

Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent

et al. 2009

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“…These most commonly result from endoscopic manipulation or dilatations or as a complication of paraesophageal surgery, and account for up to 75% of published cases [3,[5][6][7]. In our series too, iatrogenic causes were the most important factor in EP, at a rate of 62%.…”

Section: Discussionmentioning

confidence: 54%

The Success of Surgery in the First 24 Hours in Patients with Esophageal Perforation

Bayram

Erol

Melek

et al. 2015

EAJM

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Objective: Esophageal perforation (EP) is a critical and potentially life-threatening condition with considerable rates of morbidity and mortality. Despite many advances in thoracic surgery, the management of patients with EP is still controversial. Materials and Methods:We retrospectively reviewed 34 patients treated for EP, 62% male, mean age 53.9 years. Sixty-two percent of the EPs were iatrogenic. Spontaneous and traumatic EP rates were 26% and 6%, respectively. Three patients had EP in the cervical esophagus and 31 in the thoracic esophagus.Results: Mean time to initial treatment was 34.2 hours. Twenty patients comprised the early group <24 h) and 14 patients the late group (>24 h). Management of the EP included primary closure in 30 patients, non-surgical treatment in two, stent in one and resection in one. Mortality occurred in nine of the 34 patients (26%). Mortality was EP-related in four patients. Three of the nine patients that died were in the early group (p<0.05). Mean hospital stay was 13.4 days. Conclusion:EP remains a potentially fatal condition and requires early diagnosis and accurate treatment to prevent the morbidity and mortality. Keywords: Esophageal perforation, emergency treatment, thoracic surgery ÖzetAmaç: Özofagus perforasyonları (ÖP) kritik , hayatı tehdit eden mortalite ve morbidite riski yüksek olgulardır. Göğüs Cerrahisi'ndeki tüm gelişmelere rağmen bu olgulara yaklaşım günümüzde de tartışmalıdır. Gereç ve Yöntem:ÖP nedeniyle tedavi ettiğimiz 34 hastayı retrospektif olarak değerlendirdik. Erkek hastalar tüm hastaların %62' sini oluşturmaktaydı. Ortalama yaş: 53,9 olarak saptandı. Tüm perforasyonların %62' si iatrojenik nedenlerden kaynaklanmaktaydı. Spontan ve travmatik perforasyon oranları sırasıyla %26 ve % 6 olarak hesaplandı. 3 Hastada boyunda, 31 hastada ise torasik özofagusda perforasyon saptandı. Bulgular:Tedavinin ortalama başlama süresi 34, 2 saatti. 20 hasta erken grup içindeydi (<24 saat), 14 hasta ise geç grup (>24 saat) olarak sınıflandırıldı. Cerrahi olarak; 30 hastada primer onarım,1 hastada özofagus rezeksiyon ve anastamoz, 1 hastada stent ve 2 hastada medikal tedavi uygulandı. Mortalite 9 hastada gelişti %26. Mortalite nedeni 4 hastada ÖP'a sekonderdi. 9 Hastanın 3' ü erken tedavi grubundaydı (p<0,05). Ortalama hastanede yatış süresi 13,4 gündü. Sonuç: ÖP potansiyel ölümcül sonuçlar doğurabileceğinden morbidite ve mortaliteyi azaltmak için erken tanı ve etkili tedavi gereklidir. Anahtar Kelimeler: Özofagus perforasyonu, acil tedavi, göğüs cerrahisiCorrespondence to: M. Muharrem Erol,

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“…Their successful management depends on early diagnosis and prompt treatment because morbidity and mortality rise rapidly after the first 12 to 24 h [3], but no single first-line treatment has been defined for patients with intrathoracic esophageal perforations [8,9].…”

Section: Discussionmentioning

confidence: 99%

Use of self-expandable metal stents for the treatment of esophageal perforations and anastomotic leaks

2009

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Treatment and outcomes of oesophageal perforation in a tertiary referral centre☆

Cited by 78 publications

References 12 publications

Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent

Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent

The Success of Surgery in the First 24 Hours in Patients with Esophageal Perforation

Use of self-expandable metal stents for the treatment of esophageal perforations and anastomotic leaks

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