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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Lindenmann, J; Matzi, V; Neuboeck, N; Anegg, U; Maier, A; Smolle, J; Smolle-Juettner, FM.
Management of esophageal perforation in 120 consecutive patients: clinical impact of a structured treatment algorithm.
J Gastrointest Surg. 2013; 17(6):1036-1043
Doi: 10.1007/s11605-012-2070-8
Web of Science
PubMed
FullText
FullText_MUG
- Leading authors Med Uni Graz
- Lindenmann Jörg
- Co-authors Med Uni Graz
- Anegg Udo
- Fink-Neuböck Nicole
- Maier Alfred
- Matzi Veronika
- Smolle Josef
- Smolle-Juettner Freyja-Maria
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- Abstract:
- The therapy of esophageal perforation is still challenging. The aim of this study was to assess the etiology, specific treatment, and outcome of esophageal disruption in order to generate an optimal therapeutic approach to improve patient's outcome. We reviewed the cases of 120 consecutive patients with esophageal perforation treated within 10 years. Iatrogenic perforation was the most frequent cause of esophageal perforation (58.3 %); Boerhaave's syndrome was detected in 15 cases (6.8 %). Surgery was performed in 66 patients (55 %), 17 (14 %) patients received conservative treatment and 37 (31 %) patients underwent endoscopic stenting after tumorous perforation. Statistically significant impact on mean survival had Boerhaave's syndrome (p = 0.005), initial sepsis (p = 0.002), pleural effusion/empyema (p = 0.001), mediastinitis (p = 0.003), peritonitis (p = 0.001), and redo-surgery (p = 0.000). Overall mortality rate was 11.7 %, in the esophagectomy group 17 % and in the patients with Boerhaave's syndrome 33.3 %. An approach considering etiology and extent of perforation, diagnostic delay, and septic status is required to improve patient's outcome. Primary repair is feasible in patients without intrinsic esophageal disease and evidence of sepsis. The greater the diagnostic delay, the more the destruction of the esophageal wall especially in the case of septic esophageal disease, thus the stronger the argument for esophagectomy if anatomically and/or oncologically possible.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Aged, 80 and over -
- Algorithms -
- Esophageal Perforation - complications Esophageal Perforation - etiology Esophageal Perforation - therapy
- Esophagectomy - adverse effects
- Esophagoscopy - adverse effects
- Female -
- Humans -
- Iatrogenic Disease -
- Length of Stay -
- Male -
- Mediastinal Diseases - therapy
- Middle Aged -
- Retrospective Studies -
- Sepsis - etiology
- Stents -
- Survival Analysis -
- Time Factors -
- Young Adult -
- Find related publications in this database (Keywords)
- Esophagus
- Esophageal injury
- Esophageal surgery
- Mediastinal infection
- Sepsis