Bykov V P, Fedoseev V F, Sobinin O V, Baranov S N
Vestn Khir Im I I Grek. 2015;174(1):36-9.
The article presents the results of treatment of 95 patients with iatrogenic damages and perforations caused by other reasons and spontaneous rupture of the esophagus. A defect of the esophagus was formed in thoracic part in 67.4% cases. Combined suppurative complications such as a neck phlegmon, mediastinitis, pleural empyema, pericarditis, pneumonia and lung abscess occurred in prevalent majority of patients. Surgical interventions were performed through cervical, thoracotomical and laparoscopical accesses. Different plastic methods of covering sutures of the esophagus were used in conditions of suppurative inflammation in 33 patients. An inconsistency of sutures was noted in 6 (18.2%) cases. Postoperative lethality consisted of 34.6% in spontaneous rupture of the esophagus and it was 11.9% in case of other damages.
本文介绍了95例因医源性损伤、其他原因导致的穿孔以及食管自发性破裂患者的治疗结果。67.4%的病例食管缺损形成于胸段。绝大多数患者出现了如颈部蜂窝织炎、纵隔炎、胸膜脓胸、心包炎、肺炎和肺脓肿等合并化脓性并发症。通过颈部、开胸和腹腔镜入路进行了手术干预。33例患者在化脓性炎症情况下采用了不同的食管覆盖缝合整形方法。6例(18.2%)出现缝线不牢固情况。食管自发性破裂患者术后死亡率为34.6%,其他损伤患者的术后死亡率为11.9%。