Minimally invasive treatment of esophageal perforation using a multidisciplinary treatment algorithm: a case series

Successful outcomes with management of esophageal perforation have depended on the time elapsed between perforation and diagnosis, size of rupture, degree of contamination, and underlying health of the patient. With the advent of minimally invasive techniques, the management of esophageal perforations has shifted towards less-invasive therapies. We reviewed eleven patients with acute esophageal perforation presenting to our tertiary care center. Of all esophageal perforations, 91% were intrathoracic and 64% were iatrogenic perforations occurring within 4 cm of the gastroesophageal junction. All patients were treated within 24 hours of initial presentation or transfer. Leak occlusion was confirmed within 24 hours of esophageal stent placement. Median length of stay and time that the stents remained in place was 15 and 13 days, respectively. Endoscopic removable esophageal stents with aggressive conservative therapy is an effective method of treatment for patients with esophageal perforation.