Griffin S C, Desai J, Townsend E R, Fountain S W
Department of Thoracic Surgery, Harefield Hospital, Middlesex, UK.
Eur J Cardiothorac Surg. 1990;4(4):211-3. doi: 10.1016/1010-7940(90)90007-m.
Between 1981 and 1987, 11 patients underwent oesophageal resection following endoscopic perforation of the oesophagus. They had a median age of 67 years with a range of 36 to 88 years. They all were managed either by one- or two-stage oesophageal resections. Six patients were perforated at other hospitals, 5 on site. Seven had carcinoma of the middle or lower third of the oesophagus, 2 of these were perforated at attempted palliative intubation. Four had benign peptic strictures perforated during dilatation. Seven were resected within the first 24 hours and 4 between 2 and 10 days after perforation. All 4 patients with benign disease survived but 4 of the 7 patients with cancer died giving an operative mortality of 36.3%. Respiratory complications were the most common postoperative problem: all deaths were attributed to respiratory failure. Perforation of the thoracic oesophagus carries a high mortality. Resection after perforation in benign strictures may be life saving in a potentially lethal condition but resection after perforation, even in operable cancer, still carries a high mortality.
1981年至1987年间，11例患者在食管内镜穿孔后接受了食管切除术。他们的年龄中位数为67岁，范围在36至88岁之间。他们均接受了一期或二期食管切除术。6例患者在其他医院发生穿孔，5例在本院发生穿孔。7例患有食管中下段癌，其中2例在姑息性插管尝试时发生穿孔。4例在扩张过程中发生良性消化性狭窄穿孔。7例在穿孔后24小时内接受切除，4例在穿孔后2至10天接受切除。所有4例良性疾病患者均存活，但7例癌症患者中有4例死亡，手术死亡率为36.3%。呼吸并发症是最常见的术后问题：所有死亡均归因于呼吸衰竭。胸段食管穿孔的死亡率很高。良性狭窄穿孔后进行切除在可能致命的情况下可能挽救生命，但即使是可手术切除的癌症，穿孔后进行切除仍具有很高的死亡率。
