Multidisciplinary approach to esophageal perforation

In this report 36 patients were included. Group A: 9 cervical perforations (4 with lesion of the respiratory tree); Group B: 7 lesions of the thoracic esophagus; Groups C: 18 esophageal carcinomas with fistulae; Group D: 2 non-malignant fistulae. Therapeutic options and results: Group A: surgical repair; 4 respiratory tree simultaneous repairs (1 esophagocoloplasty in a fistula to the larynx); 8 patients regained normal function, I died with healed reparations. Group B: 5 surgical repair; 2 bi-polar exclusions; in a patient with cancer an esophagectomy was subsequently performed; 5 patients regained a regular swallowing and the 2 patients with a bi-polar exclusion died of septic events. Group C and D: endoscopic placement of an esophageal prosthesis (metallic auto-expansive 17, poliuretan 3), all patients resumed oral feeding and the fistulae were sealed.