Two-tube method for treatment of spontaneous esophageal rupture and concomitant mediastinal infection. Issue 4 (April 2018)

• Record Type: Journal Article
• Authors: Yu, Liang-liang; He, Zheng-fu; Liu, Qi-fang; Dai, Ning; Si, Jian-min; Ye, Bei; Zhou, Jian-cang
• Is Part Of: Journal of international medical research. Volume 46:Issue 4(2018)
• Page Start: 1528
• Page End: 1536
• Publication Date: 2018-04
• Subjects: Two-tube method -- spontaneous esophageal rupture -- endoscopic therapy -- jejunal feeding tube -- minimally invasive treatment -- closure rate; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060517752995
• Languages: English
• ISSNs: 0300-0605

Abstract

Objective: Spontaneous esophageal rupture (SER) is a rare but life-threatening condition with high mortality. The prognosis of patients with SER treated with surgical intervention or the traditional "three-tube" method is controversial. Thus, the aim of this study was to evaluate the clinical efficacy, feasibility, and safety of a new "two-tube" method involving a trans-fistula drainage tube and a three-lumen jejunal feeding tube for the treatment of SER without concomitant pleural rupture. Methods: From January 2007 to June 2016, patients with SER and managed with the "two-tube" method or other methods were retrospectively analyzed. Data collected included initial presentation, procedure time, duration of treatment, numbers of patients with eventual healing of leaks, and complications. Results: The average procedure time for the "two-tube" method was 22.1 ± 5.5 minutes. In comparison with the control method, the "two-tube" method had a similar diagnosis time (3.6 ± 1.4 vs. 3.4 ± 1.4 days) but a significantly higher successful closure rate (94.4% vs. 63.6%) and shorter treatment time (38.2 ± 5.6 vs. 53.6 ± 16.9 days). No complications associated with performance of the "two-tube" method occurred. Conclusion: The "two-tube" method is an effective and safe approach for patients with SER.