Favorable Prognosis of Esophageal Perforation in a Single Institution

Jiyun Lee, Do Yeon Kim, Jeong Seob Yoon

Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea

Purpose : Esophageal perforation is a rare but fatal condition with high morbidity and mortality. The rate of mortality is 10 to 25% when proper management is initiated within 24 hours, but increases to 40 to 60% when the treatment is delayed. Treatment depends on multi-factor including location, timing, and underlying esophageal pathology, however, the optimal treatment is unclear. This article shares the prognosis of esophageal perforation in our institution.

Methods : Between 2011 and 2020, a total of 17 patients who followed the management protocol of perforated esophagus in our institution were reviewed.

Results : In 17 patients, esophagus was perforated at cervical level in 6 patients and at thoracic level in 11 patients. Esophagus was ruptured by Boerhaave’s syndrome (n=7), foreign bodies (n=6), iatrogenic causes (n=3), and hardware irritation (n=1). 14 patients underwent primary repair of perforated esophagus and 3 patients underwent surgical drainage. The follow-up esophagography showed that 5 patients had a leakage from sites of repair. In those 5 patients, 1 patient had covered stent and the other 4 patients underwent endoscopic vacuum-assisted closure system (E-VAC). There was no mortality in the period of study.

Conclusion : The overall mortality was zero and it was significantly lower compared to previous studies. We need more experience and improved protocol with combined operative and nonoperative management.

책임저자: Jeong Seob Yoon

Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea

발표자: Jiyun Lee, E-mail : waspent10c@gmail.com