title: Esophagus perforation complicating anterior cervical spine surgery.
abstract: OBJECTIVE
  To study the diagnosis and treatment strategy of esophagus perforation complicating anterior cervical spine surgery.
  
  
  METHODS
  From 2000 to 2010, we performed 1,045 cases of anterior cervical surgeries. One developed esophagus perforation. The diagnosis and treatment strategy of this case and the other five patients with esophagus perforation from other hospitals were retrospectively reviewed. For an intraoperative perforation, primary double layer suture was performed. Postoperatively, the patient took nutrition by a nasogastric tube instead of oral intake for one week. For three cases of perforations early in the post-operative period, oral intake was forbidden and nasogastric tube was conducted for nutrition support. The wound was debrided and open drainage was conducted postoperatively. Intravenous broad-spectrum antibiotic therapy was utilized. For perforations at postoperative year 3 and 7, prohibition of oral intake, intravenous broad-spectrum antibiotics therapy, and nasogastric tube nutrition support were all conducted and surgical debridement was performed. In operation, fixation plates and screws were removed, and the edges of the perforation were loosely approximated by synthetic absorbable sutures. Postoperatively, skin wound was kept open for drainage.
  
  
  RESULTS
  All the perforations healed evenly without secondary complications.
  
  
  CONCLUSIONS
  When a perforation is suspected, imaging techniques should be employed. Surgical treatment facilitates the healing of esophagus perforation. Supportive treatments including prohibition of oral intake, intravenous broad-spectrum antibiotic therapy, feeding with a nasogastric tube were mandatory parts of treatments.
authors.affiliation: Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, People's Republic of China. xuhualu@hotmail.com
authors.forename: Xuhua
authors.initials: X
authors.lastname: Lu
authors.forename: Qunfeng
authors.initials: Q
authors.lastname: Guo
authors.forename: Bin
authors.initials: B
authors.lastname: Ni
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D004939:Esophageal Perforation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D004947:Esophagus / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods