951 Boerhaave's Outcome in a Single Tertiary Oesophago-Gastric Centre Over 5-Years

Autor: A Hashi, A Gutale, A Elnour, A Madhavan, P Singh, SR Preston, N Abbassi-Ghadi
Rok vydání: 2022
Předmět:
Zdroj: British Journal of Surgery. 109
ISSN: 1365-2168
0007-1323
Popis: Aim To present modern day outcomes for Boerhaave's in a single tertiary oesophago-gastric centre. Method This study retrospectively analysed the records of consecutive patients diagnosed with Boerhaave's between June 2016 and June 2021. Results In this case series (n=18) patients were included, male (n=14) and female (n=4), with a mean age of 61. Treatment was commenced within 24 hours of symptom onset in (n= 7;38.8%), and after (n=11; 61.1%). All Patients had an OGD performed on arrival in theatre to plan operative management. The site of the oesophageal perforation was identified as: distal third (n=14;77.8%); middle third (n=4;22.2%). Majority of patients were treated surgically (61.11%), with only seven non operatively. Within the surgical group the most common operative technique was primary repair over T-tube with intercostal drains via Thoracotomy (n=8;72.72%), followed by a trans-hiatal primary repair via a laparotomy (n=2;18.18%) or laparoscopy (n=1;9.1%). There were three major complications requiring unplanned return to theatre. One patient required a redo-thoracotomy, decortication, and evacuation of an empyema. One patient had a consistent leak post primary repair from oesophageal perforation requiring Eso-sponge vacuum therapy for further healing and closure of the tear. Another patient required a revision of feeding Jejunostomy. There was zero mortality both in hospital and in 30- and 90-days following admission. The average hospital stay was 34 days, of which 11 days was in Intensive care. Conclusion With this data, we can conclude that aggressive medical management coupled with surgical management as well as mediastinal debridement and washout resulted in no mortality.
Databáze: OpenAIRE
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