Cameron J L, Kieffer R F, Hendrix T R, Mehigan D G, Baker R R
Ann Thorac Surg. 1979 May;27(5):404-8. doi: 10.1016/s0003-4975(10)63335-8.
Eight patients with intrathoracic esophageal disruptions were managed nonoperatively and without pleural drainage. Criteria for nonoperative treatment included the following: disruption contained in the mediastinum or between the mediastinum and visceral lung pleura; drainage of the cavity back into the esophagus; minimal symptoms; and minimal signs of clinical sepsis. Cause of the esophageal perforation was pneumostatic dilatation (1 patient), vomiting (2), and a leak following esophageal operation (5). Antibiotics were administered intravenously to all patients; hyperalimentation was accomplished intravenously in 5, and nasogastric suction was used in only 1. The cavities contracted and the esophageal leaks sealed in all instances. Time before oral intake was resumed ranged from 7 to 38 days (average, 18 days). Days until discharge ranged from 15 to 52 days (average, 28 days).
8例胸段食管破裂患者采用非手术治疗且未行胸腔引流。非手术治疗的标准如下：破裂局限于纵隔内或纵隔与肺脏胸膜之间；胸腔引流液可回流入食管；症状轻微；临床脓毒症体征轻微。食管穿孔的原因包括气囊扩张（1例）、呕吐（2例）以及食管手术后漏出（5例）。所有患者均静脉给予抗生素；5例患者通过静脉进行肠外营养，仅1例患者使用鼻胃管吸引。所有病例中，胸腔均缩小，食管漏口均愈合。恢复经口进食的时间为7至38天（平均18天）。出院时间为15至52天（平均28天）。
