Wannhoff Andreas, Kouladouros Konstantinos, Koschny Ronald, Walter Benjamin, Zoll Zita, Büringer Karsten, Blank Susanne, Schempf Ulrike, Caca Karel, Wichmann Dörte
Department of Internal Medicine, Gastroenterology, Haemato-Oncology, Diabetology, and Infectiology, Hospital Ludwigsburg, Ludwigsburg, Germany.
Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Mannheim, Germany; Central Interdisciplinary Endoscopy, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany.
Gastrointest Endosc. 2025 Feb;101(2):365-374. doi: 10.1016/j.gie.2024.08.037. Epub 2024 Aug 31.
Boerhaave syndrome, an effort rupture of the esophagus, is a rare but serious condition. Endoscopic vacuum therapy (EVT) is a new therapeutic approach for GI perforation. We aimed to evaluate EVT for treatment of Boerhaave syndrome.
This retrospective study was conducted at 5 tertiary hospitals in southern Germany. All patients treated for Boerhaave syndrome since 2010 were identified and included. Treatment success and outcomes were assessed and compared between the different modes of primary treatment.
Fifty-seven patients with Boerhaave syndrome were identified (median age, 68 years; n = 16 female). The primary treatment was EVT in 25 cases, surgery in 14, and endoscopic stenting in 15. Primary EVT was successful in 20 (80.0%) of the 25 patients. Two patients were switched to surgical treatment, 1 was switched to esophageal stenting, and 2 patients died. The mortality rate was lower (P = .160) in patients treated primarily with EVT (n = 2 [8.0%]) compared with patients in the non-EVT group (n = 8 [25.0%]). Treatment success was significantly higher (P = .007) for primary EVT (80.0%) than for non-EVT (43.8%). Primary EVT was associated with treatment success in multivariable analysis.
EVT showed a high success rate for treatment of Boerhaave syndrome and was associated with treatment success.
Boerhaave综合征即食管自发性破裂，是一种罕见但严重的疾病。内镜下真空治疗（EVT）是一种治疗胃肠道穿孔的新方法。我们旨在评估EVT治疗Boerhaave综合征的效果。
这项回顾性研究在德国南部的5家三级医院进行。确定并纳入了自2010年以来所有接受Boerhaave综合征治疗的患者。评估并比较了不同初始治疗方式的治疗成功率和结局。
共确定了57例Boerhaave综合征患者（中位年龄68岁；女性16例）。初始治疗方式为EVT的有25例，手术治疗的有14例，内镜支架置入术的有15例。25例接受初始EVT治疗的患者中，20例（80.0%）治疗成功。2例患者转为手术治疗，1例转为食管支架置入术，2例患者死亡。与非EVT组患者（8例[25.0%]）相比，初始接受EVT治疗的患者死亡率较低（P = 0.160）（2例[8.0%]）。初始EVT的治疗成功率（80.0%）显著高于非EVT（43.8%）（P = 0.007）。在多变量分析中，初始EVT与治疗成功相关。
EVT治疗Boerhaave综合征成功率高，且与治疗成功相关。
