ESOPHAGOCUTANEOUS DRAINAGE TO TREAT LATE AND COMPLICATED ESOPHAGEAL-PERFORATION

被引：8
作者：
LARSSON, S
PETTERSSON, G
LEPORE, V
机构：
[1] Department of Cardiothoracic Surgery, Sahlgren’s Hospital, University of Gothenburg, Gothenburg
来源：
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1991年 / 5卷 / 11期
关键词：
LATE PERFORATION; ESOPHAGUS; T-TUBE DRAINAGE;
D O I：
10.1016/1010-7940(91)90223-7
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Five patients with complicated esophageal perforation - three with spontaneous rupture, one with dehiscence after resection of a diverticulum, and one with an iatrogenic lesion - were successfully treated by esophagocutaneous drainage of the esophageal perforation. At thoracotomy, after careful debridement and cleaning of the mediastinum and pleura, a T-tube drain was placed in the esophagus through the perforation in addition to pleural drains. A feeding jejunostomy and a gastrostomy was carried out via a separate laparatomy in 4 cases. Postoperatively the patients were managed according to a protocol with subsequent removal of pleural drains, esophageal T-tube and, after esophageal healing, gastrostomy and feeding jejunostomy. Broad-spectrum antibiotics were given initially. Healing was slow but progressive and without major problems. The healing process was followed by repeated contrast swallows. In all cases the esophagus healed without residual stenosis within 8-12 weeks. This method seems to be a way to save the life and the esophagus of patients with esophageal perforations complicated by late discovery or failure of primary repair.
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页码：579 / 582
页数：4
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