[Surgical treatment of traumatic intrathoracic esophageal perforations by foreign bone].
OBJECTIVE
To evaluate the staging criteria and surgical treatment strategy of traumatic intrathoracic esophageal perforations by foreign bone.


METHODS
Fifty-seven patients with intrathoracic esophageal perforations caused by foreign bone in our department from January 1980 to June 2006 were studied. Patients were divided into 4 grades: grade I was esophageal perforation without mediastinitis (n=17), grade II was esophageal perforation with severe mediastinitis (n=13), grade III was esophageal perforation with severe empyema (n=21), grade IV was esophageal perforation with tracheal or aorto-esophageal fistula (n=6). Based on the stage of esophageal perforation, operative procedures were selected including esophagotomy, esophageal repair, esophagectomy, mediastinal drainage, and esophagus reconstruction with colon.


RESULTS
In grade I, II and III, all but one patient experienced satisfactory healing of the esophagus. One patient died of multi-organ failure from septic complication. No leakage was observed. Normal swallowing function and improved weight gain was achieved in all the patients. There were 2 deaths in grade IV (2/6).


CONCLUSIONS
Grading of esophageal perforation caused by foreign bone is helpful to the decision of surgical treatment strategy.
Xiao
Yong-guang
YG
Department of Thoracic Surgery, The Renming Hospital, Wuhan University, Wuhan 430060, China. xygwp@yahoo.com.cn
Wang
Tu-sheng
TS
Huang
Jie
J
Cheng
Bang-chang
BC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004939:Esophageal Perforation / Q000145:classification* / Q000601:surgery; D004947:Esophagus / Q000473:pathology* / Q000601:surgery; D005260:Female; D005547:Foreign Bodies / Q000145:classification* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D055815:Young Adult