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. 2009 Jul;91(5):374-80.
doi: 10.1308/003588409X428298. Epub 2009 Apr 30.

Surgical management of Boerhaave's syndrome in a tertiary oesophagogastric centre

Robert P Sutcliffe  1 , Matthew J Forshaw, Gourab Datta, Ashish Rohatgi, Dirk C Strauss, Robert C Mason, Abraham J Botha
Affiliations

Surgical management of Boerhaave's syndrome in a tertiary oesophagogastric centre

Robert P Sutcliffe et al. Ann R Coll Surg Engl. 2009 Jul.

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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Figures

Figure 1
Figure 1
Overview of patient subgroups. NG, nasogastric; TPN, total parenteral nutrition.
See this image and copyright information in PMC

Comment in

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