Management of esophageal perforation

• Published in: Surgery today (Tokyo, Japan) Vol. 31; no. 1; pp. 36 - 39
• Main Authors: Okten, I, Cangir, A K, Ozdemir, N, Kavukçu, S, Akay, H, Yavuzer, S
• Format: Journal Article
• Language: English
• Published: Japan 01-01-2001
• Subjects: Adolescent; Adult; Aged; Child; Digestive System Surgical Procedures - methods; Esophageal Perforation - etiology; Esophageal Perforation - surgery; Female; Humans; Male; Middle Aged; Mortality; Postoperative Complications; Prognosis; Retrospective Studies; Time Factors
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s005950170217

Despite recent advances in thoracic surgery, the management of esophageal perforation remains problematical and controversial. Thirty-one patients were treated for an esophageal perforation between 1986 and 1998. The esophageal perforation was iatrogenic in 25 cases, spontaneous in 2, traumatic in 2, and caused by a tumor and tuberculous lymphadenitis in 2 patients. There were 10 cervical, 19 thoracic, and 2 abdominal perforations. The interval from perforation to operation was less than 24h in 12 patients and more than 24h in 19 patients. The surgical procedures included a primary repair in 12 patients, a resection in 8, and conservative treatment with minor surgical approaches in 11. The mortality rate was 20% (4/20 patients) in the surgical treatment group and 45.5% (5/11 patients) in the conservative treatment with minor surgery group. The overall mortality was 29% (9/31 patients). The prognosis is thus concluded to depend on the cause and location of the perforation, the presence of underlying esophageal diseases, and the surgical procedure chosen.