title: [Surgical treatment of traumatic intrathoracic esophageal perforations by foreign bone].
abstract: 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.
authors.affiliation: Department of Thoracic Surgery, The Renming Hospital, Wuhan University, Wuhan 430060, China. xygwp@yahoo.com.cn
authors.forename: Yong-guang
authors.initials: YG
authors.lastname: Xiao
authors.forename: Tu-sheng
authors.initials: TS
authors.lastname: Wang
authors.forename: Jie
authors.initials: J
authors.lastname: Huang
authors.forename: Bang-chang
authors.initials: BC
authors.lastname: Cheng
mesh_terms: 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