Article Sidebar

PDF
Date Published: 03/11/2020
Abstract Views: 267
Views PDF: 190
DOI: https://doi.org/10.47972/vjcts.v8i.267
Issue
Vol. 8
Section
Research Article
How to Cite
Minh, N. C. (2020). INVESTIGATION OF THE RELATED FACTORS ON THE FAILURE THE SURGICAL TREATMENT OF THE FORCEFUL VOMITTING OESOPHAGEAL RUPTURE IN CHO RAY - TRUNG VUONG EMERGENCY HOSPITAL, DURING 14 YEARS (1999-2012). The Vietnam Journal of Cardiovascular and Thoracic Surgery, 8, 33-39. https://doi.org/10.47972/vjcts.v8i.267

INVESTIGATION OF THE RELATED FACTORS ON THE FAILURE THE SURGICAL TREATMENT OF THE FORCEFUL VOMITTING OESOPHAGEAL RUPTURE IN CHO RAY - TRUNG VUONG EMERGENCY HOSPITAL, DURING 14 YEARS (1999-2012)

Nguyen Cong Minh

Main Article Content

Abstract

Objective: Oesophageal rupture with violent retching and vomiting is a potentially mortal
condition. Classically, the best condition is the primary repair for ruptures diagnosed early. Untill now, the recent opinions are different. The purpose of the study is analysis the clinical presentations, the results and the related factors on the failure of the surgical treatment of Boerhaave syndrome over a period of 14 years at two centers (Cho Ray and Trung Vuong hospital).
Methods: Nineteen patients were performed between january 1999 and january 2012. Mean age: 49 years, ranged from 36 to 64 years. The peak from 46 to 55 years old. All of them are men. All patients were confirmed by chest X- ray and computed tomography with contrast study swallow.
Results: The median postoperative stay was 36 days (range: 18-60 days). Mortality rate was 47% (9/19 patients). ฀ Nine patients underwent thoracotomy for primary oesophageal suture: All of them were suture line leakage and 5 died of septic shock during the first week). * ฀ Ten patients with late diagnosis and widespread inflammation from the perforation underwent thoracic drainage and continuted irrigation, 4 died: 3 of septic shock and one in state of cachexia. Six which secondary repaired thoracotomy, were good.
Conclusion: Although Boerhaave’s syndrome has a high mortality rate, primary adequate minimize surgical debridement (remove all of food remaints, the necrotic tissue) with mediastinal and pleural cavity drainage, combined with broad-spectrum antibiotics and good nutrition resulted a low mortality. Primary reconstructive surgery have an adverse effecton the daily life of these patients.

Article Details

Keywords

Boerhaave’s syndrome - Esophageal perforation - Thoracic esophageal surgery - Thracotomy - Video-assisted thoracoscopic surgery (VATS).

References

1. BENOIT D’JOURNO X, DODDOLI C. et al. (2006): “Long-Term observation and Functional State of the Esophageal Rupture”. Ann Thorac Surg.81: 1858-62.
2. CORNS RA and EDWARDS JL. (2004), “Boerhaave’s syndrome: CT diagnosis”. Ann Royal College of Surg. Engl.: 85-86.
3. FERDINAND E, ADJEPONG S. et al. (2013): “A rare but important cause of chest pain”. J of
the Royal Society of Medicine Short Reports.4: 25.
4. GRIFFI SM, LAMB PJ. et al. (2008): “Spotaneous rupture of the oesophagus”. Br J Surg. 95: 1115-1120.
5. HAVEMAN J W, NIEUWENHUIJS B et al. (2011): “Adequate debridement and drainage of the mediastinum using open thoracotomy or videoassisted thoracoscopic surgery for Boerhaave’s syndrome”. Surg Endosc.25: 2492-2497.
6. KARMAN L, IQBAL J, KUNDIL B and KOCHHAR R. (2010): “Management of Esophageal Perforation in Adults”. Gastoenterology Research. 3 (6): 235-44.
7. KHALBUSS W E, HOODA S and AUGER M. (2012): “Cytomorphology of Boerhaave’s syndrome: a critical value in cytology”. Chest. 102: 976-978.
8. LYMAN D. (2011): “Spontaneous Esophageal Perforation in a Patient with Mixed Connective Tissue Disease”. The Open Rhumatology J. 5: 138-143.
9. NGUYỄN CÔNG MINH (2005): “Hội chứng Boerhaave - Chấn thương thực quản”. Chấn thương ngực. NXB Y học. TP HCM: 150-151.
10. OCHIAI T, HIRANUMA S. et al. (2004): “Treatment strategy for Boerhaave’s syndrome”. Diseases of Esophagus. 17: 98-103.
11. SIDDIQUE K and HARINATH G. (2010): “Surgical management of Boerhaave’s syndrome
in a tertiary oesophasogastric center”. Ann Royal College of Surg. Engl. 92.: 173-74.
12. SOREIDE J A. and VISTE A. (2011): “Esophageal perforation: diagnosis work up and clinical decision-making in the first 24 hours”. Scandinavian J of trauma - Resuscitation and Emergecy Medicine.19: 66.
13. TAMATEY M N, SEREBOE L A. et al. (2013): “Boerhaave’s syndrome: Diagnosis and successful primary repair one month after the oesophageal perforation”. Ghana Medical J. 47: 53-55.
14. VENO S. and ECKARDT J. (2013): “Boerhaave’s syndrome and tention pneumothorax secondary to Norovirus induced forceful emesis”. J Thorac Dis. 5 (2): 38-40.
15. VOGEL S B, ROUT W R. et al. (2005): “Esophageal perforation in adults: aggressive, conservative treatment lowers morbidity and mortality”. Ann Surg. 241: 1016-21.