Khirurgiia · 2026
[Intrapleural vacuum bandage in the treatment of spontaneous rupture of the esophagus].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Porkhanov V A, Polyakov I S, Baryshev A G, Zhikharev V A, Kovalenko A L, Sirota A A, Akobyan A V, Sirota M V, Bondarenko E A
Аннотация
OBJECTIVE: To improve treatment of patients with spontaneous esophageal rupture by suturing the esophageal defect through thoracotomy, staged debridement of pleural cavity and posterior mediastinum with application of a vacuum-assisted dressing.
MATERIAL AND METHODS: The study involved 22 patients with spontaneous esophageal rupture. They were divided into two groups depending on treatment: group 1 (n=12) - video-assisted thoracoscopic debridement of pleural cavity with vacuum dressing in esophageal lumen (endovacuum); group 2 (n=10) - thoracotomy, debridement of esophageal cavity, suturing the lower third of the esophagus, and placement of vacuum dressing in posterior mediastinum, pleural cavity, and post-thoracotomy wound. Treatment outcomes were compared between groups.
RESULTS: Mean length of postoperative hospital stay was 52 [48-55] and 14 [12-17] days, respectively. Mortality in group 1 was 16.7% (2 patients). There were no fatal outcomes in group 2.
CONCLUSION: Esophageal wall perforation suturing no later than three days after injury through thoracotomy, thorough necrectomy, intrapleural vacuum-assisted dressing and staged pleural debridement improve the rate of favorable outcomes. This organ-sparing method is effective, significantly reduces hospital-stay and provides good quality of life in late postoperative period.
MATERIAL AND METHODS: The study involved 22 patients with spontaneous esophageal rupture. They were divided into two groups depending on treatment: group 1 (n=12) - video-assisted thoracoscopic debridement of pleural cavity with vacuum dressing in esophageal lumen (endovacuum); group 2 (n=10) - thoracotomy, debridement of esophageal cavity, suturing the lower third of the esophagus, and placement of vacuum dressing in posterior mediastinum, pleural cavity, and post-thoracotomy wound. Treatment outcomes were compared between groups.
RESULTS: Mean length of postoperative hospital stay was 52 [48-55] and 14 [12-17] days, respectively. Mortality in group 1 was 16.7% (2 patients). There were no fatal outcomes in group 2.
CONCLUSION: Esophageal wall perforation suturing no later than three days after injury through thoracotomy, thorough necrectomy, intrapleural vacuum-assisted dressing and staged pleural debridement improve the rate of favorable outcomes. This organ-sparing method is effective, significantly reduces hospital-stay and provides good quality of life in late postoperative period.
Предметные рубрики MeSH
HumansNegative-Pressure Wound TherapyDebridementEsophageal PerforationThoracotomyFemaleRupture, SpontaneousMaleMiddle AgedThoracic Surgery, Video-AssistedTreatment OutcomeMediastinal DiseasesLength of StayQuality of LifePostoperative ComplicationsSuture TechniquesAdultRussiaSpontaneous PerforationEsophageal Diseases