TY - JOUR
T1 - Thoracic esophageal perforations
AU - Kiernan, Paul D.
AU - Sheridan, Michael J.
AU - Elster, Eric
AU - Rhee, John
AU - Collazo, Lucas
AU - Byrne, William D.
AU - Fulcher, Thomas
AU - Hettrick, Vivian
AU - Vaughan, Betty
AU - Graling, Paula
PY - 2003/2/1
Y1 - 2003/2/1
N2 - Background: Recognition of the importance of early diagnosis and aggressive, definitive surgical intervention has brought about a dramatic decline in mortality related to distal esophageal perforation. Methods: We retrospectively analyzed all cases of thoracic esophageal perforation diagnosed at our hospital from September 1, 1979, through April 1, 2001. The study group consisted of 62 patients (43 men) with a mean age of 58.8 years (range, 20-92 yr). Results: In the group of 39 patients with early diagnosis (≤24 h), hospital survival was 87%, which increased to 93% when early diagnosis was combined with aggressive surgical treatment. Among the 23 patients with late diagnosis (>24 h), survival approached 70%. Yet, in patients who were treated aggressively with surgery, survival was almost 90% despite delayed diagnosis. Conclusion: We recommend aggressive, definitive surgery for thoracic esophageal perforations, whether diagnosed early or late. A variety of options are discussed with regard to complicated presentations.
AB - Background: Recognition of the importance of early diagnosis and aggressive, definitive surgical intervention has brought about a dramatic decline in mortality related to distal esophageal perforation. Methods: We retrospectively analyzed all cases of thoracic esophageal perforation diagnosed at our hospital from September 1, 1979, through April 1, 2001. The study group consisted of 62 patients (43 men) with a mean age of 58.8 years (range, 20-92 yr). Results: In the group of 39 patients with early diagnosis (≤24 h), hospital survival was 87%, which increased to 93% when early diagnosis was combined with aggressive surgical treatment. Among the 23 patients with late diagnosis (>24 h), survival approached 70%. Yet, in patients who were treated aggressively with surgery, survival was almost 90% despite delayed diagnosis. Conclusion: We recommend aggressive, definitive surgery for thoracic esophageal perforations, whether diagnosed early or late. A variety of options are discussed with regard to complicated presentations.
UR - http://www.scopus.com/inward/record.url?scp=0037328359&partnerID=8YFLogxK
U2 - 10.1097/01.SMJ.0000054566.43066.B5
DO - 10.1097/01.SMJ.0000054566.43066.B5
M3 - Article
C2 - 12630641
AN - SCOPUS:0037328359
SN - 0038-4348
VL - 96
SP - 158
EP - 163
JO - Southern Medical Journal
JF - Southern Medical Journal
IS - 2
ER -