Surgical Treatment for Patients with Esophageal Perforation

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  • 食道穿孔症例に対する外科治療の現状と治療成績

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We performed a retrospective clinical review of 11 patients surgically treated for esophageal perforation at our hospital. There were 5 iatrogenic perforations, 3 malignant perforations, 2 spontaneous perforations and one traumatic perforation. In the surgical treatment of benign esophageal perforations, 5 patients underwent primary closure, one patient underwent primary closure with an omental patch, one patient underwent partial esophageal resection and one patient underwent video assisted thoracoscopic drainage. In the surgical treatment of malignant esophageal perforations, one patient underwent thoracotomy for drainage and esophageal stenting (self-expanding metallic stent) was performed, one patient underwent thoracic tube drainage and underwent subtotal esophagectomy and reconstruction using a gastric tube, and one patient underwent naso-gastiric tube drainage and underwent an esophageal bypass using a gastric tube. As for the post-operative complications, anastomotic leakage occurred in 2 patients, pyothorax occurred in 1 patient, wound infection occurred in 1 patient, and the hospital mortality was 0%. The etiologies of esophageal perforation and the conditions of patients varied extensively, therefore the treatment of esophageal perforations should be selected appropriately according to each individual patient.

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