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.

引用

页码：579 / 582

页数：4

共 18 条

[1]

Abbott O.A., Mansour K.A., Logan C., Hatcher C.R., Symbas P.N., ) Atraumatic so-called ‘spontaneous” rupture of the esophagus. A review of 47 personal cases with comments on a new method of surgical therapy, J Thorac Cardio- Vasc Surg, 5, pp. 67-68, (1970)

[2]

Bladergroen M.R., Lowe J.E., Postlethwait R.W., Diagnosis and recommended management of esophageal perforation and rupture, Ann Thorac Surg, 42, pp. 235-239, (1986)

[3]

Bryant L.R., Experimental evaluation of intercostal pedicle graft in esophageal repair, J Thorac Cardiovasc Surg, 50, pp. 626-631, (1965)

[4]

Demeester T.R., Perforation of the esophagus, Ann Thorac Surg, 42, pp. 231-232, (1986)

[5]

Grillo H.C., Wilkins E.W., Esophageal repair following late diagnosis of perforation, Ann Thorac Surg, 20, pp. 387-398, (1975)

[6]

Harrison M.W., Lindell T.D., Brant B., Surgical treatment of late esophageal perforation, Am Surg, 42, (1976)

[7]

Hopper C.L., Berk P.D., Howes E.L., Strength of esophageal anastomoses repaired with autogenous pericardial grafts, Surg Gynecol Obstet, 117, pp. 83-86, (1963)

[8]

Johnson J., Schwegman C.W., Kirby C.K., Esophageal exclusion for persistent fistula following spontaneous rupture of the esophagus, J Thorac Cardiovasc Surg, 32, pp. 827-832, (1956)

[9]

Larsson S., Pettersson G., Advisability of concomitant immediate surgery for perforation and underlying disease of the esophagus, Scand J Thorac Cardiovasc Surg, 18, pp. 275-278, (1984)

[10]

Mathisen D.J., Grillo H.C., Vlahakes G.J., Daggett W.M., The omentum in the management of complicated cardiothoracic problems, J Thorac Cardiovasc Surg, 95, pp. 677-684, (1988)

← 1 2 →