Selective approach in the treatment of esophageal perforations.

摘要: Background: Treatment of esophageal perforation remains controversial and recommendations vary from initially non‐operative to aggressive surgical management. Several factors are responsible for this life‐threatening event, which has led more individualized treatment ensuring adequate pleuromediastinal drainage with sufficient irrigation. We analyzed our data, evaluating morbidity mortality in selective approach. Methods: During 1985 2001, 17 the 38 patients treated hospital underwent primarily a thoracotomy, wide debridement chest/mediastinum enteral hyperalimentation. Twenty‐one (55%) were non‐operatively (NPO, nasogastric tube, hyperalimentation, antibiotics chest tube), but surgery was required 9 (43%). Results: Most perforations iatrogenic (45%; 17/38) followed by spontaneous (32%; 12/38). Cervical managed earlier (<24 h) than thoracic tears, 8/10 (80...