Introduction: Esophageal perforations occur spontaneously or as a complication of endoscopic procedures. Especially in spontaneous perforation there is ongoing debate regarding the best treatment options.
Methods: 24 patients that were treated at two surgical centers (University Halle, City-hospital Bielefeld) after spontaneous esophageal perforations between 1996 and 2005 were analysed retrospectively.
Results: All patients but one underwent surgical treatment with in 2 cases additional stent implantation. Average stay in hospital was 53 days. In-hospital-lethality was 25% (overall lethality 37.5%). Concerning the therapeutic outcome there was no link between patients' age, localization or size of the perforation and the time interval between perforation and treatment. In 22 patients diagnosis was made > 12hrs after the event.
Conclusions: Main problem of the Boerhaave-syndrome is the septic-toxic disease. Prognostic criteria are the patients' health-state and not factors like size of perforation, time of delay or localization of the perforation. Since in case of survival esophageal resection shows good long-term-results, in doubt a radical surgical procedure should be recommended as primary option. Implanting an esophageal stent might become a useful mean of treating patients with spontaneous perforations.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/s-2006-955447 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Inspiratory effort and respiratory muscle activation during different breathing conditions in patients with weaning difficulties: An exploratory study.
Aust Crit Care
January 2025
KU Leuven, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, B-3000, Leuven, Belgium; University Hospitals Leuven, Department of Intensive Care Medicine, Leuven, Belgium.
Background: Recent studies suggest that fast and deep inspirations against either low or high external loads may provide patients with weaning difficulties with a training stimulus during inspiratory muscle training (IMT). However, the relationship between external IMT load, reflected by changes in airway pressure swings (ΔPaw), and total inspiratory effort, measured by oesophageal pressure swings (ΔPes), remains unexplored. Additionally, the association between ΔPes, ΔPaw, and inspiratory muscle activations remains unclear.
View Article and Find Full Text PDFExperience in the treatment of type C congenital esophageal atresia using a staged approach.
BMC Surg
January 2025
Department of Neonatal Surgery, National Center for Children's Health, Beijing Children Hospital, Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China.
Background: In select patients with type C esophageal atresia, primary anastomosis is not appropriate and a staged approach is required. We aim to summarize our experience in the management of type C EA using a staged approach.
Methods: A retrospective chart-review of patients with type C EA admitted to Beijing Children's Hospital between July 2020 to October 2023 were conducted.
Oxygen consumption, effort, and weaning in the mechanically ventilated patient in the intensive care unit: The extubate study: A protocol for an observational study.
Respir Med
January 2025
Department of Intensive Care, Leiden University Medical Center, 2333 ZA, Leiden, the Netherlands. Electronic address:
Purpose: The spontaneous breathing trial (SBT) is often performed to determine whether the patient can be extubated with a minimal risk of failure. The rapid shallow breathing index (RSBI) is an important parameter used in an SBT. However, weaning failure rates are between 15 and 20 %.
View Article and Find Full Text PDFDouble cycling with breath-stacking during partial support ventilation in ARDS: Just a feature of natural variability?
Crit Care
January 2025
Departamento de Medicina, Hospital Clínico Universidad de Chile, Unidad de Pacientes Críticos, Dr. Carlos Lorca Tobar 999, Independencia, Santiago, Chile.
Background: Double cycling with breath-stacking (DC/BS) during controlled mechanical ventilation is considered potentially injurious, reflecting a high respiratory drive. During partial ventilatory support, its occurrence might be attributable to physiological variability of breathing patterns, reflecting the response of the mode without carrying specific risks.
Methods: This secondary analysis of a crossover study evaluated DC/BS events in hypoxemic patients resuming spontaneous breathing in cross-over under neurally adjusted ventilatory assist (NAVA), proportional assist ventilation (PAV +), and pressure support ventilation (PSV).
Multidisciplinary management of early esophageal fistula after anterior cervical spine surgery: a case report emphasizing team-based care.
Wound Manag Prev
December 2024
The First Affiliated Hospital, Unit of Nurses, Zhejiang University School of Medicine, Hangzhou, China.
Background: Early esophageal fistula formation following anterior cervical spine surgery presents a formidable clinical challenge, necessitating astute rehabilitative nursing management. Such fistulas, if not promptly and effectively managed, can precipitate grave complications including mediastinitis, sepsis, respiratory failure, and, in severe instances, mortality. This underscores the critical need for immediate, comprehensive nursing interventions designed to mitigate these risks and enhance patient outcomes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!