title: Management of esophageal perforation: experience from a tertiary center in India.
abstract: OBJECTIVE
  The management of esophageal perforations remains controversial in large part due to variability in etiology, time of presentation, location, and underlying esophageal disease. We reviewed our experience in treating patients with esophageal perforations and evaluated the etiology, management and outcome of intervention in a tertiary center.
  
  
  METHODS
  Between 1999 and 2007, 48 patients with esophageal perforation were treated in a tertiary referral center in southern India. Postdilatation corrosive stricture perforations constituted the major etiology.
  
  
  RESULTS
  Thirty (62.5%) patients were diagnosed early (<24 h) and the remaining 18 (37.5%) were late (>24 h). The 30-day mortality was 6.2%, and mean hospital stay was 13 +/- 9.3 days. Comparing outcomes between early and late groups, statistically significant difference was observed, with increased mortality (p = 0.02) and hospital stay (p = 0.04) following late diagnosis.
  
  
  CONCLUSIONS
  This report suggests that early diagnosis decreases mortality and hospital stay in esophageal perforation. Preservation of esophagus may be attempted while treating esophageal perforations.
authors: Institute of Surgical Gastroenterology, Centre for GI Bleed and Division of Hepato-Biliary Pancreatic Diseases, Gastroenterology Block, Government Stanley Medical College Hospital, The Tamilnadu Dr. MGR Medical University, Chennai 600001, India.
authors: Anbalagan
authors: A
authors: Amudhan
authors: Shanmugasundaram
authors: S
authors: Rajendran
authors: Vellayudham Vimal
authors: VV
authors: Raj
authors: Govindhasamy
authors: G
authors: Rajarathinam
authors: D
authors: D
authors: Jyotibasu
authors: Palanisamy
authors: P
authors: Ravichandran
authors: Satyanesan
authors: S
authors: Jeswanth
authors: Tirupporur Govindaswamy
authors: TG
authors: Balachandar
authors: Devy Gounder
authors: DG
authors: Kannan
authors: Rajagopal
authors: R
authors: Surendran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002985:Clinical Protocols; D004939:Esophageal Perforation / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016629:Esophagectomy / Q000379:methods*; D004946:Esophagostomy / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007194:India / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult