Five Cases of Spontaneous Esophageal Perforation of the Lower Thoracic and Abdominal Esophagus Treated with Laparoscopic Surgery

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  • 胸部下部および腹部食道における特発性食道破裂に対する腹腔鏡手術5例の経験

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Abstract

<p>Spontaneous esophageal perforation, which is a rupture of the whole layer of the esophageal wall due to an increase in esophageal pressure, is a critical disease with high mortality. The standard procedure for treatment of spontaneous esophageal perforation is surgery with conventional thoracotomy, but some recent reports have described surgery with thoracoscopy or laparoscopy. We reviewed 5 cases of spontaneous esophageal perforation treated with laparoscopic surgery in our hospital between December 2013 and October 2018. The sites of perforation were in the left wall of the lower thoracic esophagus (n=1) and in the left wall of the abdominal esophagus (n=4). The perforated area was repaired by hand-sewn sutures and covered by the fundus of the stomach in all cases. The median operation time was 190 min and the median blood loss was 10 ml. Two cases had pleural effusion and one had pneumonia as postoperative complications, but there was no anastomotic leakage and no mortality. These outcomes indicate that laparoscopic surgery has an acceptable operation time and enables reliable and less invasive repair of the perforated area. Thus, we believe that it is a useful procedure for treatment of spontaneous esophageal perforation of the lower thoracic and abdominal esophagus.</p>

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