TY - JOUR

T1 - Videotorakoskopisk behandling af øsofagusperforationer

AU - Christensen, Merete

AU - Petersen, René Hornsleben

AU - Hansen, Henrik Jessen

PY - 2008/4/7

Y1 - 2008/4/7

N2 - INTRODUCTION: Esophageal perforation can within hours result in seriously-ill patients with a high risk of complications. The array of treatment options is many and minimal invasive methods are emerging.MATERIALS AND METHODS: Six patients with esophageal perforations, who were managed successfully by thoracoscopic debridement, irrigation and drainage. The causes of the lesions and the importance of early diagnosis are described. The different treatment schemes are outlined, and the specifics of this thoracoscopic approach are described. The importance of port placement is underlined and illustrated in Figure 1.RESULTS: The six patients with a median age of 70.5 years (29-80) were successfully treated with videothoracoscopic debridement, irrigation with saline and drainage. Median time in surgery was 91.5 min. and the in-hospital time was 17.5 days. There were no complications except for one patient with continuous bacterial contamination of the pleural cavity, necessitating chest tube treatment for weeks after discharge. No patient was re-operated nor had a fatal course.DISCUSSION: The potential applications of thoracoscopic surgery as a minimal invasive treatment for esophageal perforations are discussed, as well as the advantages of a combination of videothorascopic drainage and placement of a covered expandable stent. This combination must be evaluated in future studies.

AB - INTRODUCTION: Esophageal perforation can within hours result in seriously-ill patients with a high risk of complications. The array of treatment options is many and minimal invasive methods are emerging.MATERIALS AND METHODS: Six patients with esophageal perforations, who were managed successfully by thoracoscopic debridement, irrigation and drainage. The causes of the lesions and the importance of early diagnosis are described. The different treatment schemes are outlined, and the specifics of this thoracoscopic approach are described. The importance of port placement is underlined and illustrated in Figure 1.RESULTS: The six patients with a median age of 70.5 years (29-80) were successfully treated with videothoracoscopic debridement, irrigation with saline and drainage. Median time in surgery was 91.5 min. and the in-hospital time was 17.5 days. There were no complications except for one patient with continuous bacterial contamination of the pleural cavity, necessitating chest tube treatment for weeks after discharge. No patient was re-operated nor had a fatal course.DISCUSSION: The potential applications of thoracoscopic surgery as a minimal invasive treatment for esophageal perforations are discussed, as well as the advantages of a combination of videothorascopic drainage and placement of a covered expandable stent. This combination must be evaluated in future studies.

KW - Adult

KW - Aged

KW - Debridement

KW - Drainage

KW - Esophageal Perforation/complications

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Minimally Invasive Surgical Procedures/methods

KW - Risk Factors

KW - Stents

KW - Therapeutic Irrigation

KW - Thoracic Surgery, Video-Assisted/instrumentation

KW - Treatment Outcome

M3 - Tidsskriftartikel

C2 - 18433581

VL - 170

SP - 1242

EP - 1245

JO - Ugeskrift for Laeger

JF - Ugeskrift for Laeger

SN - 0041-5782

IS - 15

ER -