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PubMed2000

[Surgical treatment of distal esophageal perforation not due to a malignancy: results in 11 patients, University Medical Center Utrecht, 1994-1998].

OBJECTIVE: To describe the surgical treatment of distal oesophageal perforation and its results. DESIGN: Retrospective. METHODS: From patient records data were collected on 11 patients, 6 men and 5 women (median age: 54 years; range: 21-76) who underwent surgery for distal oesophageal perforation in Utrecht University Medical Centre. There were 7 iatrogenic perforations, 3 after vomiting and 1 perforation was based on an oesophageal stricture. Four patients had a delay < 24 h and 7 > 24 h (range: 6-27 days). Nine presented with sepsis, mediastinitis and empyema. Seven underwent primary repair: 5 in combination with a hemifundoplication, 2 with omentomplasty. In the group of other surgical treatment, 2 had drainage with extension and diversion, 1 had an oesophageal resection and gastric conduit and 1 had only surgical drainage. RESULTS: Primary repair resulted in 7/7 survival. The median period of hospital stay was 24 days (range: 10-62), and the median stay on the ICU was 14 days (range: 0-21). Four patients underwent reoperation. Four patients with primary repair presented no functional complaints, 1 had reflux complaints and 2 dysphagia. Two out of four within other surgery survived the perforation.

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