Adequate debridement and drainage of the mediastinum using open thoracotomy or video-assisted thoracoscopic surgery for Boerhaave’s syndrome
| Autor: | H. Sijbrand Hofker, Gooitzen M. van Dam, Jeroen P. Muller Kobold, J. T. Plukker, Jan Willem Haveman, Vincent B. Nieuwenhuijs |
|---|---|
| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE) |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Perforation (oil well) Video-assisted PERFORATION Article Esophagus Esophageal perforation PRIMARY ESOPHAGEAL REPAIR Mediastinal Diseases MANAGEMENT Humans Medicine Prospective Studies Thoracotomy Aged Thoracic Surgery Video-Assisted business.industry General surgery Mediastinum Middle Aged Pleural cavity Surgery Thoracic surgery medicine.anatomical_structure Debridement Cardiothoracic surgery Video-assisted thoracoscopic surgery SPONTANEOUS RUPTURE Drainage Female business Abdominal surgery |
| Zdroj: | Surgical endoscopy and other interventional techniques, 25(8), 2492-2497. SPRINGER Surgical Endoscopy |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | Background Boerhaave's syndrome has a high mortality rate (14-40%). Surgical treatment varies from a minimal approach consisting of adequate debridement with drainage of the mediastinum and pleural cavity to esophageal resection. This study compared the results between a previously preferred open minimal approach and a video-assisted thoracoscopic surgery (VATS) procedure currently considered the method of choice.Methods In this study, 12 consecutive patients treated with a historical nonresectional drainage approach (1985-2001) were compared with 12 consecutive patients treated prospectively after the introduction of VATS during the period 2002-2009. Baseline characteristics were equally distributed between the two groups.Results In the prospective group, 2 of the 12 patients had the VATS procedure converted to an open thoracotomy, and 2 additional patients were treated by open surgery. In the prospective group, 8 patients experienced postoperative complications compared with all 12 patients in the historical control group. Four patients (17%), two in each group, underwent reoperation. Six patients, three in each group, were readmitted to the hospital. The overall in-hospital mortality was 8% (1 patient in each group), which compares favorably with other reports (7-27%) based on drainage alone.Conclusions Adequate surgical debridement with drainage of the mediastinum and pleural cavity resulted in a low mortality rate. The results for VATS in this relatively small series were comparable with those for an open thoracotomy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink