Outcomes after oesophageal perforation: a retrospective cohort study of patients with different aetiologies
| Autor: | Jonathan Yl Chan, Desmond Kk Chan, TT Law, Daniel Tong, Ian Y H Wong, Simon Law, Fion Sy Chan |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Perforation (oil well) 030230 surgery Malignancy Cohort Studies Hospitals University 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Mediastinal Diseases Humans Hospital Mortality Aged Retrospective Studies Aged 80 and over Esophageal Perforation business.industry Mortality rate Retrospective cohort study General Medicine Middle Aged medicine.disease Foreign Bodies Surgery Esophagectomy 030220 oncology & carcinogenesis Cohort Etiology Hong Kong Female Stents business Cohort study |
| Zdroj: | Hong Kong medical journal = Xianggang yi xue za zhi. 23(3) |
| ISSN: | 1024-2708 |
| Popis: | INTRODUCTION The mortality rate after oesophageal perforation is high despite advances in operative and non-operative techniques. In this study, we sought to identify risk factors for hospital mortality after oesophageal perforation treatment. METHODS We retrospectively examined patients treated for oesophageal perforation in a university teaching hospital in Hong Kong between January 1997 and December 2013. Their demographic and clinical characteristics, aetiology, management strategies, and outcomes were recorded and analysed. RESULTS We identified a cohort of 43 patients treated for perforation of the oesophagus (28 men; median age, 66 years; age range, 30-98 years). Perforation was spontaneous in 22 (51.2%) patients (15 with Boerhaave's syndrome and seven with malignant perforation), iatrogenic in 15 (34.9%), and provoked by foreign body ingestion in six (14.0%). Of the patients, 14 (32.6%) had pre-existing oesophageal disease. Perforation occurred in the intrathoracic oesophagus in 30 (69.8%) patients. Emergent surgery was undertaken in 23 patients: 16 underwent primary repair, six surgical drainage or exclusion, and one oesophagectomy. Twenty patients were managed non-operatively, 13 of whom underwent stenting. Two stented patients subsequently required oesophagectomy. Four patients had clinical signs of leak after primary repair: two were treated conservatively and two required oesophagectomy. Overall, six (14.0%) patients required oesophagectomy, one of whom died. Nine other patients also died in hospital; the hospital mortality rate was 23.3%. Pre-existing pulmonary and hepatic disease, and perforation associated with malignancy were significantly associated with hospital mortality (P=0.03 |
| Databáze: | OpenAIRE |
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