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ID 46498
file
creator
Ono, Kosuke
Sakimoto, Hideto
Fukuhara, Sotaro
Imaoka, Koki
Sawada, Hiroyuki
Shishida, Masayuki
Fujisaki, Seiji
Hirata, Yuzo
Fukuda, Saburo
Takahashi, Mamoru
subject
Oesophageal perforation
Boerhaave’s syndrome
transabdominal approach
NDC
Medical sciences
abstract
Spontaneous oesophageal perforation is an uncommon and life-threatening disease. Although several methods of treatment have been proposed, surgical treatment is considered the standard procedure. Primary repair using the transthoracic approach is the most common. However, few studies have evaluated the characteristics of the transabdominal approach. This study aimed to investigate the clinical outcomes of spontaneous oesophageal perforation that was surgically treated using the transabdominal approach. We retrospectively reviewed all patients with spontaneous oesophageal perforation who were admitted to the surgical department of our institution between November 2010 and April 2017, and identified a total of four patients. Data including demographic factors (age and sex), location of perforation, time to operation, operative method, complications, length of hospital stay, and postoperative recovery were reviewed. In all four cases, we treated the defect using the transabdominal approach, which provides a good surgical field of view. The aims of operative intervention, namely primary repair and access for enteral feeding, can be achieved using this approach. The most commonly observed complication was pyothorax, and we suggest the addition of intrapleural drainage for its prevention. Dysgraphia was observed in two patients, which improved with conservative treatment. The overall mortality rate was 0%. Our results demonstrate that primary repair using the transabdominal approach is safe and effective for the management of spontaneous oesophageal perforation. Addition of intrapleural drainage can improve the outcome associated with this approach.
journal title
Hiroshima Journal of Medical Sciences
volume
Volume 67
issue
Issue 3
start page
93
end page
96
date of issued
2018-09
publisher
Hiroshima University Medical Press
issn
0018-2052
2433-7668
ncid
publisher doi
language
eng
nii type
Departmental Bulletin Paper
HU type
Departmental Bulletin Papers
DCMI type
text
format
application/pdf
text version
publisher
rights
Copyright (c) 2018 Hiroshima University Medical Press
relation url
department
Graduate School of Biomedical & Health Sciences
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