title: The surgical management of spontaneous esophageal perforation (Boerhaave's syndrome) ‒ 20 years of experience.
abstract: Spontaneous esophageal perforation (Boerhaave's syndrome) is an uncommon and challenging condition with significant morbidity and mortality. Surgical treatment is indicated in the large majority of cases and different procedures have been described in this respect. We present the results of a mono-institutional evaluation of the management of spontaneous esophageal perforation over a 20-year period. The charts of 25 patients with spontaneous esophageal perforation treated at the Surgical Department of the University Hospital of Lausanne were retrospectively studied. In the 25 patients, 24 patients were surgically treated and one was managed with conservative treatment. Primary buttressed esophageal repair was performed in 23 cases. Nine postoperative complications were recorded, and the overall mortality was 32%. Despite prompt treatment postoperative morbidity and mortality are still relevant. Early diagnosis and definitive surgical management are the keys for successful outcome in the management of spontaneous esophageal perforation. Primary suture with buttressing should be considered as the procedure of choice. Conservative approach may be applied in very selected cases.
authors.affiliation: Department of Surgery, Ospedale Regionale.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Pezzetta
authors.forename: Takashi
authors.initials: T
authors.lastname: Kokudo
authors.forename: Emilie
authors.initials: E
authors.lastname: Uldry
authors.forename: Takamune
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kudo
authors.forename: Hans-Beat
authors.initials: HB
authors.lastname: Ris
authors.forename: Michel
authors.initials: M
authors.lastname: Christodoulou
authors.forename: Henri
authors.initials: H
authors.lastname: Vuilleumier
authors.forename: Nermin
authors.initials: N
authors.lastname: Halkic
mesh_terms: D004939:Esophageal Perforation / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D004935:Esophageal Diseases; D012422:Rupture, Spontaneous; D000072663:Spontaneous Perforation