Thoracoscopic primary repair with mediastinal drainage is a viable option for patients with Boerhaave's syndrome

Toru Nakano, Ko Onodera, Hirofumi Ichikawa, Takashi Kamei, Yusuke Taniyama, Tadashi Sakurai, Go Miyata

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: Spontaneous esophageal rupture (Boerhaave's syndrome) is an emergency that can cause life-threatening conditions. Various procedures have been used to treat Boerhaave's syndrome. However, a standard surgical procedure has not been established. Herein, we report our experience with primary suture of the ruptured esophagus via a thoracoscopy or laparotomy. Methods: Between November 2002 and May 2015, 11 patients with Boerhaave's syndrome presented to our department and were managed using one of two surgical procedures based on the surgeon's discretion. Six patients underwent a thoracoscopic primary suture and drainage (group A); 5 patients underwent a primary suture via laparotomy followed by thoracoscopic drainage (group B). Patient medical records were retrospectively reviewed. Results: The mean interval between initial perforation and surgery was 13.7 h (group A) and 17.2 h (group B) (P=0.7307). The mean operative time was 190 min (group A) and 249 min (group B) (P=0.106). Patient baseline characteristics and surgical outcomes were similar for both surgical procedures. One patient in each group experienced postoperative leakage that did not require surgical intervention. Conclusions: The results suggest that thoracoscopic esophageal repair, as well as suturing via laparotomy, is a good surgical alternative for patients with Boerhaave's syndrome.

Original languageEnglish
Pages (from-to)784-789
Number of pages6
JournalJournal of Thoracic Disease
Volume10
Issue number2
DOIs
Publication statusPublished - 2018 Feb 1

Keywords

  • Esophagus
  • Laparotomy
  • Mediastinitis
  • Reinforcement
  • Suture

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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