title: [Esophageal perforation: analysis of seven cases treated by early surgical treatment with good functional results].
abstract: BACKGROUND
  Esophageal perforation has been considered a catastrophic and often life-threatening event, with very high mortality rates. Most of the cases are due to a complication in endoscopic manouvers and the best treatment, conservative rather than aggressive, remains a controversial topic.
  
  
  METHODS
  In 1995-2005 period we observed 7 cases of esophageal perforation, 5 women and 2 men mean age 73.2 y (range 60-87). Three cases are due to foreign body ingestion, 2 cases to endoscopic manoeuvres, 2 cases were spontaneous. In 3 cases the lesion was in the cervical tract of the esophagus, in the thoracic tract the others. All the patients were admitted very early to our Unit and presented disphagia, vomiting and dyspnoea, 2 out of them also a pleural effusion. In iatrogenic perforation we performed a cervicotomy and a drainage of mediastinic abscess, while in spontaneous lesions mono (one case) or bipolar esophageal exclusion (one case) with primary suture, jujunostomy and drainage of pleural effusion were the treatment. In foreign body perforation we performed thoracotomic and cervicotomic esophagotomy, extraction of the foreign body, direct suture with pleural or muscle protection. We didn't observe any intra or post-operative mortality. About the complications, we observed a bilateral pleural empyema, a chylous fistula, a digestive bleeding due to gastric ulcer, a laparotomic infection, a parossistic FA and a persistent esophageal fistula. Mean hospital stay was 24.3 days (range 10-43). All the patients were discharged to the hospital in good conditions.
  
  
  CONCLUSIONS
  In conclusion in most of the cases of esophageal perforation the surgical treatment is the treatment of choice for its lower morbidity and mortality and good functional results.
authors.affiliation: U.O. Chirurgia Toracica, Presidio Ospedaliero "Morgagni-Pierantoni", Forlì.
authors.forename: Stefano
authors.initials: S
authors.lastname: Sanna
authors.forename: Marco
authors.initials: M
authors.lastname: Taurchini
authors.forename: Marta
authors.initials: M
authors.lastname: Mengozzi
authors.forename: Marco
authors.initials: M
authors.lastname: Monteverde
authors.forename: Desiderio
authors.initials: D
authors.lastname: Argnani
authors.forename: Davide
authors.initials: D
authors.lastname: Dell'Amore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004939:Esophageal Perforation / Q000209:etiology / Q000601:surgery*; D005260:Female; D005547:Foreign Bodies / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D013514:Surgical Procedures, Operative / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome