Defore W W, Mattox K L, Hansen H A, Garcia-Rinaldi R, Beall A C, DeBakey M E
Am J Surg. 1977 Dec;134(6):734-8. doi: 10.1016/0002-9610(77)90313-0.
Although well protected and infrequently injured, penetration of the esophagus has a reported mortality of 10 to 30 per cent. The results of the management of seventy-seven patients with noniatrogenic penetrating injuries of the esophagus were reviewed. The region of esophageal injury was cervical in forty-five patients, intrathoracic in twenty-one patients, and intraabdominal in eleven patients. Gunshot wounds accounted for 75 per cent of the injuries. The overall mortality was 23 per cent. The highest morbidity and mortality was among patients with intrathoracic injuries, due to both difficulty in exposure and complexity of associated injuries. Because of the high incidence of late complications in intrathoracic injuries, cervical diversion and tube gastrostomy or complete esophageal exclusion must be considered early. Fundoplastic procedures were used in four patients with distal esophageal injuries. Although the overall mortality from truncal penetrating wounds has improved in recent years, the mortality from esophageal injuries remains high, reflecting a need for advancement in initial operative management.
尽管食管受到良好保护且很少受伤，但据报道食管穿透伤的死亡率为10%至30%。回顾了77例非医源性食管穿透伤患者的治疗结果。食管损伤部位为颈部45例，胸内21例，腹内11例。枪伤占损伤的75%。总死亡率为23%。胸内损伤患者的发病率和死亡率最高，这是由于暴露困难和相关损伤的复杂性所致。由于胸内损伤后期并发症的发生率很高，必须尽早考虑行颈部转流术和胃造瘘术或完全食管旷置术。4例食管远端损伤患者采用了胃底成形术。尽管近年来躯干穿透伤的总体死亡率有所改善，但食管损伤的死亡率仍然很高，这反映出在初始手术治疗方面需要取得进展。
