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Danielyan Sh.N.

Sklifosovsky Research Institute for Emergency Medicine

Abakumov M.M.

Sklifosovsky Research Institute for Emergency Care

Tarabrin E.A.

Sklifosovsky Research Institute for Emergency Medicine

Rabadanov K.M.

Sklifosovsky Research Institute for Emergency Medicine

Surgical treatment of spontaneous esophageal rupture: long-term experience of the Sklifosovsky Research Institute for Emergency Care

Authors:

Danielyan Sh.N., Abakumov M.M., Tarabrin E.A., Rabadanov K.M.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2021;(5): 50‑57

DOI: 10.17116/hirurgia202105150

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To cite this article:

Danielyan ShN, Abakumov MM, Tarabrin EA, Rabadanov KM. Surgical treatment of spontaneous esophageal rupture: long-term experience of the Sklifosovsky Research Institute for Emergency Care. Pirogov Russian Journal of Surgery. 2021;(5):50‑57. (In Russ.)
https://doi.org/10.17116/hirurgia202105150

Подписка 2025 (Pirogov Russian Journal of Surgery)
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OBJECTIVE

To analyze the treatment outcomes in patients with spontaneous esophageal rupture (SER).

MATERIAL AND METHODS

The study included 106 patients with SER admitted to the Sklifosovsky Research Institute for the period from 1992 to 2015. The sample also included 91 patients who were referred from other hospitals. All patients were divided into 4 groups depending on surgical procedure: surgical drainage (Group I, n=19); suturing the esophageal defect without antireflux surgery (Group II, n=12); esophageal wall repair with fundoplication procedure (Group III, n=62); resection of the thoracic esophagus (Group IV, n=13).

RESULTS

In the 1st group, complication rate was 100% and significantly exceeded these values in groups II, III, and IV (66.7%, 71%, and 69.2%, respectively; p=0.0318, p=0.0189, and p=0.0413). The length of hospital-stay was the lowest in group IV (mean 42 days) and group I (mean 55 days). Mortality rate in groups I, III and IV was 15—20% lower than in group II. Pneumonia and pleural empyema were significant predictors of poor outcome. Fundoplication improved postoperative outcomes in group III compared to group II. Resection of the thoracic esophagus performed in accordance with strict indications interrupts infectious process and shortens recovery period. Surgical drainage is followed by persistent contamination of mediastinum and pleural cavities that may quickly result a fatal outcome.

CONCLUSION

A differentiated approach to SER treatment can reduce the risk of complications and mortality.

Keywords:

spontaneous esophageal rupture
Boerhaave’s syndrome
esophageal perforation

Authors:

Danielyan Sh.N.

Sklifosovsky Research Institute for Emergency Medicine

Abakumov M.M.

Sklifosovsky Research Institute for Emergency Care

Tarabrin E.A.

Sklifosovsky Research Institute for Emergency Medicine

Rabadanov K.M.

Sklifosovsky Research Institute for Emergency Medicine

Received:

09.06.2020

Accepted:

10.07.2020

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