A rational surgical approach for intra-thoracic esophageal perforation

The surgical experiences of intrathoracic esophageal perforation in 17 consecutive cases seen during the last eight years are reviewed. Using a rational approach to this critical condition, the mortality and morbidity rates were lower than before. For acute perforation in a corrosive-injured esophagus, subtotal esophagectomy by eversion stripping was an effective procedure for life saving. For acute perforation of a normal or chronic fibrotic but functional esophagus, early primary repair was usually successful for healing. For chronic esophageal perforation, usually complicated by mediastinal abscess or purulent pleural effusion, an adequate local drainage or supplemented with a newly designed, temporary diversion procedure for drainage of saliva and gastric acid was recommended.