Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan.
Asian J Endosc Surg. 2020 Jul;13(3):406-409. doi: 10.1111/ases.12754. Epub 2019 Sep 17.
Boerhaave's syndrome is a rare life-threatening disease that requires prompt intervention. Thoracotomy has traditionally been considered the gold standard approach for treatment, but other minimally invasive approaches have recently been reported. Our institute reported the efficacy of minimally invasive abdominal and left thoracic approach in the treatment of patients with esophagogastric junction cancer and introduced it for the treatment of two patients with Boerhaave's syndrome. We intraoperatively sutured the rupture sites and irrigated the pleural cavity using thoracoscopy. Then, after confirming the absence of intraabdominal contamination, we performed jejunostomy or gastrostomy using laparoscopy. Patients' vital signs remained stable intraoperatively, and their postoperative periods were uneventful with no leakage or stricture. The minimally invasive abdominal and left thoracic approach for Boerhaave's syndrome is convenient and useful as it provides excellent visualization of the thoracic and abdominal cavities with the possibility of quickly switching between views.
布氏综合征是一种罕见的危及生命的疾病，需要及时干预。传统上，开胸手术被认为是治疗的金标准方法，但最近也有报道采用其他微创方法。我们研究所报告了微创腹部和左胸入路治疗食管胃交界部癌的疗效，并将其用于治疗 2 例布氏综合征患者。我们在胸腔镜下缝合破裂部位并用冲洗胸腔。然后，在确认无腹腔污染后，我们使用腹腔镜进行空肠造口术或胃造口术。患者术中生命体征稳定，术后无并发症，无渗漏或狭窄。微创腹部和左胸入路治疗布氏综合征方便有效，因为它可以提供胸腔和腹腔的极好可视化，并有可能快速切换视图。
