ISSN 1308-8734 | E-ISSN 1308-8742
Original Article
The Success of Surgery in the First 24 Hours in Patients with Esophageal Perforation
1 Department of Thoracic Surgery, Uludag University Faculty of Medicine, Bursa, Turkey  
Eurasian J Med 2015; 47: 41-47
DOI: 10.5152/eajm.2014.55
Key Words: Esophageal perforation, emergency treatment, thoracic surgery
Abstract

Objective: Esophageal perforation (EP) is a critical and potentially life-threatening condition with considerable rates of morbidity and mortality. Despite many advances in thoracic surgery, the management of patients with EP is still controversial.

 

Materials and Methods: We retrospectively reviewed 34 patients treated for EP, 62% male, mean age 53.9 years. Sixty-two percent of the EPs were iatrogenic. Spontaneous and traumatic EP rates were 26% and 6%, respectively. Three patients had EP in the cervical esophagus and 31 in the thoracic esophagus.

 

Results: Mean time to initial treatment was 34.2 hours. Twenty patients comprised the early group <24 h) and 14 patients the late group (>24 h). Management of the EP included primary closure in 30 patients, non-surgical treatment in two, stent in one and resection in one. Mortality occurred in nine of the 34 patients (26%). Mortality was EP-related in four patients. Three of the nine patients that died were in the early group (p<0.05). Mean hospital stay was 13.4 days.

 

Conclusion: EP remains a potentially fatal condition and requires early diagnosis and accurate treatment to prevent the morbidity and mortality.

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