Factors affecting the outcome of surgically treated non-iatrogenic traumatic cervical esophageal perforation: 28 years experience at a single center.
BACKGROUND
We reviewed our experience with non-iatrogenic traumatic cervical esophageal perforations, paying particular attention to factors affecting the outcome of such cases.


METHODS
In total, 30 patients treated surgically between 1980 and 2008 for non-iatrogenic traumatic cervical esophageal perforation in our clinic were reviewed.


RESULTS
There were 25 male and 5 female patients with a median age of 27.5 years. The type of injury was external trauma in 21 (70%) patients and endoluminal injury in the remaining 9 (30%) patients. The mechanism of injury was gunshot in 16 patients, stabbing in 4, falling in 1 (extraluminal injury), and foreign body in 9 (endoluminal injuries). The overall mortality rate was 16.6% (5/30). The mortality rate for extraluminal injuries was 19%, and for endoluminal injuries was 11.1%. Mortality in patients treated within 24 h of sustaining injury was substantially less than in those for whom diagnosis and treatment were delayed (12.5 and 21.4%, respectively). The mortality rate was 33.3% (3/9) for patients with tracheal injuries and 9.5% (2/21) for those without tracheal injuries.


CONCLUSIONS
A treatment delay greater than 24 h, the presence of tracheal injury, or extraluminal perforation significantly affected the outcome of surgically treated non iatrogenic traumatic cervical esophageal perforation.
Department of Thoracic Surgery, Faculty of Medicine Dicle University, Diyarbakir, Turkey. onatserdar21@hotmail.com
Serdar
S
Onat
Refik
R
Ulku
Kemal M
KM
Cigdem
Alper
A
Avci
Cemal
C
Ozcelik
D000328:Adult; D004939:Esophageal Perforation / Q000401:mortality / Q000601:surgery*; D004947:Esophagus / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications; D016896:Treatment Outcome