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Management of post dilatation oesophageal perforation: an experience from a tertiary centre
Anbalagan Amudhan1, Tirupporur Govindaswamy Balachandar, Shanmugasundaram Rajendran
1Institute of Surgical Gastroenterology, Centre for GI bleed & Division of Hepato Biliary Pancreatic Diseases, Gastroenterology Block, Government Stanley Medical College Hospital, Chennai, India.
Background:
Treatment of oesophageal perforation remains controversial. This study shows that native oesophagus should be preserved. Early recognition improves survival.
Aim:
The aim of this study was to evaluate the outcome of management of post dilatation oesophageal perforation in a tertiary centre.
Methods:
Between 1999 and 2007, 35 patients with oesophageal perforation following dilatation were treated. Post dilatation corrosive stricture perforations constituted the major aetiology.
Results:
Twenty-four (69%) underwent early intervention (< 24 hours) and the remaining 11 (31%) were late (>24 hours). The 30-day mortality was found to be 9%, and mean hospital stay was 14 ± 14.7 days. Comparing outcomes between early and late groups, statistically significant difference was observed, with increased mortality (p=0.001) and hospital stay (p=0.001) following late intervention.
Conclusion:
Early intervention decreases mortality and hospital stay in oesophageal perforation and preservation of oesophagus may be attempted, as native oesophagus is the best conduit.
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