[Intrapleural vacuum bandage in the treatment of spontaneous rupture of the esophagus].

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.