Kita Ryosuke, Kobayashi Hiroyuki, Nakao Kai, Iwaki Kentaro, Kondo Masato, Kaihara Satoshi
Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Case Rep Gastroenterol. 2022 Jun 17;16(2):406-412. doi: 10.1159/000525011. eCollection 2022 May-Aug.
Spontaneous esophageal perforation in Boerhaave's syndrome results in significant morbidity and mortality. The gold standard treatment for this disease is thoracotomy and laparotomy because it can be a life-saving procedure that can be performed in emergencies; however, minimally invasive surgery has recently been reported. This report describes three cases of Boerhaave's syndrome that were treated using laparoscopic transhiatal suture and omental patch. One patient recovered uneventfully and was discharged from the hospital after 12 days. The other 2 patients had postoperative complications, such as minor leakage and remnant abscess (Clavien-Dindo Grade II), but were discharged from the hospital after 17 days and 30 days, respectively. In the case of Boerhaave's syndrome with localized mediastinal collections, a good clinical course can be obtained by laparoscopic transhiatal esophageal repair to avoid surgical invasion due to thoracotomy.
博赫哈夫综合征中的自发性食管穿孔会导致严重的发病率和死亡率。该病的金标准治疗方法是开胸手术和剖腹手术，因为这是一种可在紧急情况下实施的挽救生命的手术；然而，最近有关于微创手术的报道。本报告描述了3例采用腹腔镜经裂孔缝合和网膜补片治疗的博赫哈夫综合征病例。1例患者恢复顺利，术后12天出院。另外2例患者出现术后并发症，如轻微渗漏和残余脓肿（Clavien-Dindo二级），但分别于术后17天和30天出院。对于伴有局限性纵隔积液的博赫哈夫综合征，通过腹腔镜经裂孔食管修复术可获得良好的临床病程，以避免开胸手术带来的手术创伤。
