Management of esophageal perforation.
Despite recent advances in thoracic surgery, the management of esophageal perforation remains problematical and controversial. Thirty-one patients were treated for an esophageal perforation between 1986 and 1998. The esophageal perforation was iatrogenic in 25 cases, spontaneous in 2, traumatic in 2, and caused by a tumor and tuberculous lymphadenitis in 2 patients. There were 10 cervical, 19 thoracic, and 2 abdominal perforations. The interval from perforation to operation was less than 24h in 12 patients and more than 24h in 19 patients. The surgical procedures included a primary repair in 12 patients, a resection in 8, and conservative treatment with minor surgical approaches in 11. The mortality rate was 20% (4/20 patients) in the surgical treatment group and 45.5% (5/11 patients) in the conservative treatment with minor surgery group. The overall mortality was 29% (9/31 patients). The prognosis is thus concluded to depend on the cause and location of the perforation, the presence of underlying esophageal diseases, and the surgical procedure chosen.
Okten
I
I
Department of Thoracic Surgery, Ankara University Medical School, Turkey.
Cangir
A K
AK
Ozdemir
N
N
Kavukçu
S
S
Akay
H
H
Yavuzer
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004939:Esophageal Perforation / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors