Surgical management of intrathoracic oesophageal rupture
Surgical management of intrathoracic oesophageal rupture
复制标题
胸内食管破裂的手术治疗
DOI：
10.1002/bjs.1800810623
复制
发表时间：
1994
影响因子：
9.6
通讯作者：
J. Richardson
中科院分区：
文献类型：
--
作者：
S. Sabanathan;J. Eng;J. Richardson
胸内食管破裂是一种危及生命的疾病，如果要避免死亡或严重的长期疾病，需要早期诊断和有效治疗。连续六例胸内食管破裂患者接受了纵隔清创和冲洗、一期缝合闭合以及带蒂大网膜加固缝合线的治疗。 5 名患者破裂的原因是布尔哈夫综合征，1 名患者的食管因压缩空气损伤而破裂。除一名患者外，所有患者均在症状出现后 24 小时以上就诊，平均 38 小时（范围 12-72）小时。所有患者术后恢复良好，未出现食管漏。平均住院时间为 11·5（范围 9-15）天。无论食管破裂的持续时间如何，都需要积极复苏并立即进行初步缝合闭合，并用血管良好的带蒂组织瓣加固缝合线，以获得最佳结果。
Intrathoracic oesophageal rupture is a life‐threatening condition that requires early diagnosis and effective treatment if death or serious prolonged illness is to be avoided. Six consecutive patients with intrathoracic oesophageal rupture were treated by debridement and irrigation of the mediastinum and primary suture closure with reinforcement of the suture line by pedicled omentum. The cause of the rupture was Boerhaave's syndrome in five patients and compressed air injury to the oesophagus in one. All but one patient presented more than 24 h after onset of symptoms, with a mean of 38 (range 12–72) h. All the patients recovered well with no postoperative oesophageal leakage. The mean hospital stay was 11·5 (range 9–15) days. Irrespective of the duration of the oesophageal rupture, aggressive resuscitation and prompt primary suture closure with reinforcement of the suture line with a well vascularized pedicled tissue flap is required for optimal results.