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Thorac Cardiovasc Surg 1997; 45(6): 269-272
DOI: 10.1055/s-2007-1013747
Original Thoracic

© Georg Thieme Verlag Stuttgart · New York

Surgical Management of Late Esophageal Perforation

Y. Sakamoto1 , N. Tanaka2 , T. Furuya2 , T. Ueno2 , H. Okamoto2 , M. Nagai2 , T. Murakawa2 , T. Takayama2 , K. Mafune1 , M. Makuuchi1 , M. Nobori2
  • 1Second Department of Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan
  • 2Department of Surgery, Asahi General Hospital, Chiba, Japan
Further Information

Publication History

1997

Publication Date:
19 March 2008 (online)

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Abstract

Over sixteen years we have gained experience in the delayed surgical management of esophageal rupture in nine patients who received treatments more than 24 hours after perforation. The causes of perforation were Boerhaave's syndrome or barotrauma in four patients, foreign bodies in two, and other causes in three. Three patients presented in septic shock and four in respiratory failure. Three surgical options were used for treatment: simple thoracic drainage in two patients, T-tube placement in four, and esophagectomy with secondary reconstruction in three. Eight patients (89%) survived. T-tube placement was effective in that it was a one-stage operation which could be used on severe esophageal injuries in patients in poor general condition. Three patients who underwent esophagectomy and secondary alimentary restoration required long hospital stays (119,201, and 648 days). Although the number of cases is small, T-tube insertion for the late management of esophageal rupture appears to be a simple and effective method which avoids the postoperative complications associated with primary closure or two-stage operations.

Key words

Esophagus - Rupture - Perforation

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