Management of Esophageal Perforation
Management of Esophageal Perforation
复制标题
食管穿孔的治疗
DOI：
10.1007/s005950170217
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发表时间：
2001
期刊：
影响因子：
2.5
通讯作者：
Ş. Yavuzer
中科院分区：
文献类型：
--
作者：
I. Ökten;A. Cangır;N. Özdemir;Ș. Kavukc̦u;H. Akay;Ş. Yavuzer
尽管最近胸外科取得了进展，但食道穿孔的处理仍然存在问题和争议。1986年至1998年间，31名患者因食道穿孔而接受治疗。食道穿孔医源性25例，自发性2例，外伤性2例，肿瘤和结核性淋巴结炎2例。颈部穿孔10例，胸部穿孔19例，腹部穿孔2例。穿孔至手术时间<24 h者12例，>24 h者19例。手术方式包括一期修补12例，切除8例，小手术保守治疗11例。手术组死亡率为20%(4/20)，保守治疗小手术组死亡率为45.5%(5/11)。总死亡率为29%(9/31例)。因此，预后取决于穿孔的原因和位置，潜在的食道疾病的存在，以及所选择的外科手术。
Despite recent advances in thoracic surgery, the management of esophageal perforation remains problematical and controversial. Thirty-one patients were treated for an esophageal perforation between 1986 and 1998. The esophageal perforation was iatrogenic in 25 cases, spontaneous in 2, traumatic in 2, and caused by a tumor and tuberculous lymphadenitis in 2 patients. There were 10 cervical, 19 thoracic, and 2 abdominal perforations. The interval from perforation to operation was less than 24 h in 12 patients and more than 24 h in 19 patients. The surgical procedures included a primary repair in 12 patients, a resection in 8, and conservative treatment with minor surgical approaches in 11. The mortality rate was 20% (4/20 patients) in the surgical treatment group and 45.5% (5/11 patients) in the conservative treatment with minor surgery group. The overall mortality was 29% (9/31 patients). The prognosis is thus concluded to depend on the cause and location of the perforation, the presence of underlying esophageal diseases, and the surgical procedure chosen.