Esophagocutaneous drainage to treat late and complicated esophageal perforation

Open Access
Publisher Website
Google Scholar
Abstract
Five patients with complicated esophageal perforation--three withspontaneous rupture, one with dehiscence after resection of a diverticulum,and one with an iatrogenic lesion--were successfully treated byesophagocutaneous drainage of the esophageal perforation. At thoracotomy,after careful debridement and cleaning of the mediastinum and pleura, aT-tube drain was placed in the esophagus through the perforation inaddition to pleural drains. A feeding jejunostomy and a gastrostomy wascarried out via a separate laparatomy in 4 cases. Postoperatively thepatients were managed according to a protocol with subsequent removal ofpleural drains, esophageal T-tube and, after esophageal healing,gastrostomy and feeding jejunostomy. Broad-spectrum antibiotics were giveninitially. Healing was slow but progressive and without major problems. Thehealing process was followed by repeated contrast swallows. In all casesthe esophagus healed without residual stenosis within 8-12 weeks. Thismethod seems to be a way to save the life and the esophagus of patientswith esophageal perforations complicated by late discovery or failure ofprimary repair.

This publication has 0 references indexed in Scilit: