Temporary exclusion of the perforated esophagus using a linear vascular stapler: a new surgical treatment.
OBJECTIVE
A new technique using a linear staple suture for temporary exclusion of the perforated esophagus is presented.


METHODS
The procedure is combined with diversion of esophageal fluid by nasogastric tube and drainage of the periesophageal compartments by silicon drains. A gastrostomy is used to drain the stomach for 48 hours, and later for enteral nutrition. Since the suture line reopens spontaneously after approximately 10 days there is no need of reoperation.


RESULTS
This method allows diversion of esophageal fluids and therefore enhances effective healing of esophageal perforations after primary repair. Complete spontaneous recanalization of the esophagus occurs approximately two weeks after operation.


CONCLUSIONS
The combination of primary repair of an esophageal perforation with esophageal exclusion by using a linear stapler and diversion of esophageal fluid contents by naso-esophageal tube and gastrostomy is a simple effective procedure. Further experience and studies may be needed to verify the usefulness and place of this technique in armamentarium of the visceral surgeon.
Holzinger
F
F
Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, Switzerland.
Metzger
A
A
Barras
J P
JP
Baer
H U
HU
D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods; D004750:Enteral Nutrition; D004939:Esophageal Perforation / Q000601:surgery*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008722:Methods; D013528:Surgical Staplers