Surgical management of Boerhaave's syndrome in a tertiary oesophagogastric centre
- PMID: 19409144
- PMCID: PMC2758430
- DOI: 10.1308/003588409X428298
Surgical management of Boerhaave's syndrome in a tertiary oesophagogastric centre
Abstract
Introduction: The aim of this study was to review the management and outcome of patients with Boerhaave's syndrome in a specialist centre between 2000-2007.
Patients and methods: Patients were grouped according to time from symptoms to referral (early, < 24 h; late, > 24 h). The effects of referral time and management on outcomes (oesophageal leak, reoperation and mortality) were evaluated.
Results: Of 21 patients (early 10; late 11), three were unfit for surgery. Of the remaining 18, immediate surgery was performed in 8/8 referred early and 6/10 referred late. Four patients referred late were treated conservatively. Oesophageal leak (78% versus 12.5%; P < 0.05) and mortality (40% versus 0%; P < 0.05) rates were higher in patients referred late. For patients referred late, mortality was higher in patients managed conservatively (75% versus 17%; not significant).
Conclusions: The best outcomes in Boerhaave's syndrome are associated with early referral and surgical management in a specialist centre. Surgery appears to be superior to conservative treatment for patients referred late.
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Comment in
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Comment on: Surgical management of Boerhaave's syndrome in a tertiary oesophagogastric centre.Ann R Coll Surg Engl. 2010 Mar;92(2):173-4; author reply 174. doi: 10.1308/003588410X12628812459210. Ann R Coll Surg Engl. 2010. PMID: 20353646 Free PMC article. No abstract available.
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