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Selected Publication:
Tomaselli, F; Maier, A; Pinter, H; Smolle-Jüttner, F.
Management of iatrogenous esophagus perforation.
Thorac Cardiovasc Surg. 2002; 50(3):168-173
Doi: 10.1055/s-2002-32410
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Maier Alfred
- Pinter Hans
- Smolle-Juettner Freyja-Maria
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- Abstract:
- OBJECTIVES: The management of patients with iatrogenous, instrumentally caused esophageal disruptions is still a controversially discussed challenge for any physician. We reviewed indications, morbidity, and mortality of esophagectomy compared to less aggressive treatment schemes in the light of our single-unit experience. PATIENTS AND METHODS: We reviewed the cases of 38 consecutive patients suffering from iatrogenous esophageal disruption treated within the last 10 years at the University Medical School Graz. RESULTS: Severe sepsis was diagnosed in seventeen patients; fourteen of the seventeen patients were treated by esophagectomy followed by primary or secondary reconstruction at a mortality rate of 28.6 % (four of fourteen patients). All fourteen patients thus treated had major preexisting esophageal pathologies. In three of the total seventeen cases reviewed, conservative treatment modalities were used. The mortality rate in the non-septic group treated by direct suturing (n = 21) was 4.8 % (one of twenty-one patients). Major preexisting esophageal pathology was present in thirteen. The overall mortality was 13.2 % (five of thirty-eight patients). CONCLUSION: The strategy of primary repair for iatrogenous esophageal injury should only be adopted in patients with minor or without intrinsic esophageal disease, and in the absence of severe sepsis suggesting mediastinitis. Severe sepsis following iatrogenous esophageal trauma should prompt the decision for esophagectomy where anatomically and/or oncologically possible.
- Find related publications in this database (using NLM MeSH Indexing)
- Esophageal Diseases - surgery
- Esophageal Perforation - complications
- Esophagectomy - complications
- Esophagus - radiography
- Humans - radiography
- Iatrogenic Disease - radiography
- Retrospective Studies - radiography
- Sepsis - etiology
- Find related publications in this database (Keywords)
- esophageal perforation
- iatrogenous
- repair management