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Minimally invasive approach to Boerhaave's syndrome: a pilot study of three cases.
- Source :
-
Surgical Endoscopy & Other Interventional Techniques . Sep2002, Vol. 16 Issue 9, p1354-1357. 4p. - Publication Year :
- 2002
-
Abstract
- <bold>Background: </bold>Boerhaave's syndrome requires urgent thoracotomy, laparotomy, or both for esophageal repair and pleuromediastinal debridement. Minimally invasive techniques may be suitable alternatives.<bold>Materials and Methods: </bold>Over a period of 12 months, three patients with spontaneous esophageal perforations after forceful vomiting were treated by a combination of minimally invasive techniques including laparoscopy, thoracoscopy, mediastinoscopy, and endoscopic stenting.<bold>Results: </bold>Esophageal repair was performed transhiatally via laparoscopy using primary suture, primary suture reinforced by a fundic patch, and fundic patch alone in one patient each. One patient had a second perforation of the proximal esophagus, which was sutured through a cervical incision. This patient successfully underwent secondary endoscopic stenting for a persistent esophageal fistula. Mediastinal debridement was performed transhiatally and also by means of a mediastinoscope introduced via the cervical incision in one patient. One patient required secondary thoracoscopic debridement of a pleural empyema but died of sepsis after 1 month. The two other patients recovered and were discharged from the hospital after 2 and 8 weeks, respectively.<bold>Conclusions: </bold>Boerhaave's syndrome is amenable to minimally invasive techniques. Avoidance of a formal thoracotomy with its resulting morbidity could be of considerable benefit to these critically ill patients. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 16
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 50025412
- Full Text :
- https://doi.org/10.1007/s00464-001-9185-4