Evaluation of urgent esophagectomy in esophageal perforation
Autor(a) principal: | |
---|---|
Data de Publicação: | 2014 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202014000400247 |
Resumo: | BACKGROUND: Esophageal trauma is considered one of the most severe lesions of the digestive tract. There is still much controversy in choosing the best treatment for cases of esophageal perforation since that decision involves many variables. The readiness of medical care, the patient's clinical status, the local conditions of the perforated segment, and the severity of the associated injuries must be considered for the most adequate therapeutic choice. AIM: To demonstrate and to analyze the results of urgent esophagectomy in a series of patients with esophageal perforation. METHODS: A retrospective study of 31 patients with confirmed esophageal perforation. Most injuries were due to endoscopic dilatation of benign esophageal disorders, which had evolved with stenosis. The diagnosis of perforation was based on clinical parameters, laboratory tests, and endoscopic images. The main surgical technique used was transmediastinal esophagectomy followed by reconstruction of the digestive tract in a second surgical procedure. Patients were evaluated for the development of systemic and local complications, especially for the dehiscence or stricture of the anastomosis of the cervical esophagus with either the stomach or the transposed colon. RESULTS: Early postoperative evaluation showed a survival rate of 77.1% in relation to the proposed surgery, and 45% of these patients presented no further complications. The other patients had one or more complications, being pulmonary infection and anastomotic fistula the most frequent. The seven patients (22.9%) who underwent esophageal resection 48 hours after the diagnosis died of sepsis. At medium and long-term assessments, most patients reported a good quality of life and full satisfaction regarding the surgery outcomes. CONCLUSIONS: Despite the morbidity, emergency esophagectomy has its validity, especially in well indicated cases of esophageal perforation subsequent to endoscopic dilation for benign strictures. |
id |
CBCD-1_9143614596b5aedc8abf692b86575b15 |
---|---|
oai_identifier_str |
oai:scielo:S0102-67202014000400247 |
network_acronym_str |
CBCD-1 |
network_name_str |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
repository_id_str |
|
spelling |
Evaluation of urgent esophagectomy in esophageal perforationThoracic surgeryEsophagectomyTrauma BACKGROUND: Esophageal trauma is considered one of the most severe lesions of the digestive tract. There is still much controversy in choosing the best treatment for cases of esophageal perforation since that decision involves many variables. The readiness of medical care, the patient's clinical status, the local conditions of the perforated segment, and the severity of the associated injuries must be considered for the most adequate therapeutic choice. AIM: To demonstrate and to analyze the results of urgent esophagectomy in a series of patients with esophageal perforation. METHODS: A retrospective study of 31 patients with confirmed esophageal perforation. Most injuries were due to endoscopic dilatation of benign esophageal disorders, which had evolved with stenosis. The diagnosis of perforation was based on clinical parameters, laboratory tests, and endoscopic images. The main surgical technique used was transmediastinal esophagectomy followed by reconstruction of the digestive tract in a second surgical procedure. Patients were evaluated for the development of systemic and local complications, especially for the dehiscence or stricture of the anastomosis of the cervical esophagus with either the stomach or the transposed colon. RESULTS: Early postoperative evaluation showed a survival rate of 77.1% in relation to the proposed surgery, and 45% of these patients presented no further complications. The other patients had one or more complications, being pulmonary infection and anastomotic fistula the most frequent. The seven patients (22.9%) who underwent esophageal resection 48 hours after the diagnosis died of sepsis. At medium and long-term assessments, most patients reported a good quality of life and full satisfaction regarding the surgery outcomes. CONCLUSIONS: Despite the morbidity, emergency esophagectomy has its validity, especially in well indicated cases of esophageal perforation subsequent to endoscopic dilation for benign strictures. Colégio Brasileiro de Cirurgia Digestiva2014-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202014000400247ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.27 n.4 2014reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD)instacron:CBCD10.1590/S0102-67202014000400005info:eu-repo/semantics/openAccessAQUINO,José Luis Braga deCAMARGO,José Gonzaga Teixeira deCECCHINO,Gustavo NardiniPEREIRA,Douglas Alexandre RizzantiBENTO,Caroline AgnelliLEANDRO-MERHI,Vânia Aparecidaeng2015-07-27T00:00:00Zoai:scielo:S0102-67202014000400247Revistahttp://abarriguda.org.br/revista/index.php/revistaabarrigudaarepb/indexONGhttps://old.scielo.br/oai/scielo-oai.php||revistaabcd@gmail.com2317-63262317-6326opendoar:2015-07-27T00:00ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD)false |
dc.title.none.fl_str_mv |
Evaluation of urgent esophagectomy in esophageal perforation |
title |
Evaluation of urgent esophagectomy in esophageal perforation |
spellingShingle |
Evaluation of urgent esophagectomy in esophageal perforation AQUINO,José Luis Braga de Thoracic surgery Esophagectomy Trauma |
title_short |
Evaluation of urgent esophagectomy in esophageal perforation |
title_full |
Evaluation of urgent esophagectomy in esophageal perforation |
title_fullStr |
Evaluation of urgent esophagectomy in esophageal perforation |
title_full_unstemmed |
Evaluation of urgent esophagectomy in esophageal perforation |
title_sort |
Evaluation of urgent esophagectomy in esophageal perforation |
author |
AQUINO,José Luis Braga de |
author_facet |
AQUINO,José Luis Braga de CAMARGO,José Gonzaga Teixeira de CECCHINO,Gustavo Nardini PEREIRA,Douglas Alexandre Rizzanti BENTO,Caroline Agnelli LEANDRO-MERHI,Vânia Aparecida |
author_role |
author |
author2 |
CAMARGO,José Gonzaga Teixeira de CECCHINO,Gustavo Nardini PEREIRA,Douglas Alexandre Rizzanti BENTO,Caroline Agnelli LEANDRO-MERHI,Vânia Aparecida |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
AQUINO,José Luis Braga de CAMARGO,José Gonzaga Teixeira de CECCHINO,Gustavo Nardini PEREIRA,Douglas Alexandre Rizzanti BENTO,Caroline Agnelli LEANDRO-MERHI,Vânia Aparecida |
dc.subject.por.fl_str_mv |
Thoracic surgery Esophagectomy Trauma |
topic |
Thoracic surgery Esophagectomy Trauma |
description |
BACKGROUND: Esophageal trauma is considered one of the most severe lesions of the digestive tract. There is still much controversy in choosing the best treatment for cases of esophageal perforation since that decision involves many variables. The readiness of medical care, the patient's clinical status, the local conditions of the perforated segment, and the severity of the associated injuries must be considered for the most adequate therapeutic choice. AIM: To demonstrate and to analyze the results of urgent esophagectomy in a series of patients with esophageal perforation. METHODS: A retrospective study of 31 patients with confirmed esophageal perforation. Most injuries were due to endoscopic dilatation of benign esophageal disorders, which had evolved with stenosis. The diagnosis of perforation was based on clinical parameters, laboratory tests, and endoscopic images. The main surgical technique used was transmediastinal esophagectomy followed by reconstruction of the digestive tract in a second surgical procedure. Patients were evaluated for the development of systemic and local complications, especially for the dehiscence or stricture of the anastomosis of the cervical esophagus with either the stomach or the transposed colon. RESULTS: Early postoperative evaluation showed a survival rate of 77.1% in relation to the proposed surgery, and 45% of these patients presented no further complications. The other patients had one or more complications, being pulmonary infection and anastomotic fistula the most frequent. The seven patients (22.9%) who underwent esophageal resection 48 hours after the diagnosis died of sepsis. At medium and long-term assessments, most patients reported a good quality of life and full satisfaction regarding the surgery outcomes. CONCLUSIONS: Despite the morbidity, emergency esophagectomy has its validity, especially in well indicated cases of esophageal perforation subsequent to endoscopic dilation for benign strictures. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202014000400247 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202014000400247 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0102-67202014000400005 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgia Digestiva |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgia Digestiva |
dc.source.none.fl_str_mv |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.27 n.4 2014 reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD) instacron:CBCD |
instname_str |
Colégio Brasileiro de Cirurgia Digestiva (CBCD) |
instacron_str |
CBCD |
institution |
CBCD |
reponame_str |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
collection |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
repository.name.fl_str_mv |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD) |
repository.mail.fl_str_mv |
||revistaabcd@gmail.com |
_version_ |
1754208956933210112 |