Outcomes following Boerhaave's syndrome

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Esophageal Diseases

Background:

• Boerhaave's syndrome presents significant mortality and morbidity risks.
• Effective treatment strategies are crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the outcomes of Boerhaave's syndrome treatment.
• To assess the impact of surgical intervention timing and methods on patient survival.

Main Methods:

• Retrospective review of 20 patients diagnosed with Boerhaave's syndrome (1997-2011).
• Data collected from a prospectively maintained surgical audit database.
• Primary outcomes: mortality and serious morbidity; Secondary outcomes: time to theatre, operation type, and length of hospital stay.

Main Results:

• Overall in-hospital mortality was 20% (4/20 patients).
• Mean time to theatre was 2.4 days; significantly longer in non-survivors (7.3 days) vs. survivors (1.5 days).
• Non-operative management for small, contained leaks resulted in survival and shorter hospital stays.

Conclusions:

• Aggressive surgical management, including direct repair, is linked to favorable survival rates in Boerhaave's syndrome.
• Prompt surgical intervention is critical to reduce mortality.
• Non-operative management is a viable option for select patients with small, contained esophageal leaks.