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Surgical Endoscopy

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01-11-2011

A successful strategy for surgical treatment of Boerhaave’s syndrome

Authors: György Lázár Jr., Attila Paszt, Zsolt Simonka, Anett Bársony, Szabolcs Ábrahám, Gábor Horváth

Published in: Surgical Endoscopy | Issue 11/2011

Abstract

Background

This retrospective single-institution study presents a successful treatment strategy for Boerhaave’s syndrome.

Methods

During 1995–2008, 15 patients with spontaneous esophageal perforation were treated. Patients were grouped according to time from symptoms to referral (early, <24 h; late, >24 h). In group I (early, n = 8 patients) treatment comprised primary surgical esophageal repair in seven cases and endoscopic clipping in one case. In group II (late, n = 7 patients) treatment comprised esophagectomy without primary reconstruction (4 cases) or controlled esophagocutaneous fistula (3 cases). Measures of outcome included age (years), delay to diagnosis (h), severe sepsis on admission, mortality, and hospital and intensive care unit (ICU) stay.

Results

The overall hospital mortality rate was 6.6% (1/15), being 0% (0/8) in group I and 14.2% (1/7) in group II. Patient age (49.6 vs. 68.6 years, P < 0.0001), delay to diagnosis (17.75 vs. 69 h, P < 0.0001), severe sepsis on admission (0 vs. 4, P = 0.0256), and ICU stay (4 vs. 14 days, P = 0.006) were all greater in group II.

Conclusions

Early diagnosis and carefully selected therapeutic tactics can reduce the mortality rate of Boerhaave’s syndrome to an acceptably low level. Methods of organ preservation and minimally invasive techniques can be applied successfully in the treatment.

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Title: A successful strategy for surgical treatment of Boerhaave’s syndrome
Authors: György Lázár Jr.
Attila Paszt
Zsolt Simonka
Anett Bársony
Szabolcs Ábrahám
Gábor Horváth
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 11/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-011-1767-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A successful strategy for surgical treatment of Boerhaave’s syndrome

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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