title: Oesophageal resection after instrumental perforation.
abstract: Between 1981 and 1987, 11 patients underwent oesophageal resection following endoscopic perforation of the oesophagus. They had a median age of 67 years with a range of 36 to 88 years. They all were managed either by one- or two-stage oesophageal resections. Six patients were perforated at other hospitals, 5 on site. Seven had carcinoma of the middle or lower third of the oesophagus, 2 of these were perforated at attempted palliative intubation. Four had benign peptic strictures perforated during dilatation. Seven were resected within the first 24 hours and 4 between 2 and 10 days after perforation. All 4 patients with benign disease survived but 4 of the 7 patients with cancer died giving an operative mortality of 36.3%. Respiratory complications were the most common postoperative problem: all deaths were attributed to respiratory failure. Perforation of the thoracic oesophagus carries a high mortality. Resection after perforation in benign strictures may be life saving in a potentially lethal condition but resection after perforation, even in operable cancer, still carries a high mortality.
authors.affiliation: Department of Thoracic Surgery, Harefield Hospital, Middlesex, UK.
authors.forename: S C
authors.initials: SC
authors.lastname: Griffin
authors.forename: J
authors.initials: J
authors.lastname: Desai
authors.forename: E R
authors.initials: ER
authors.lastname: Townsend
authors.forename: S W
authors.initials: SW
authors.lastname: Fountain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004939:Esophageal Perforation / Q000209:etiology* / Q000601:surgery; D004945:Esophagoscopy / Q000009:adverse effects*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality