951 Boerhaave's Outcome in a Single Tertiary Oesophago-Gastric Centre Over 5-Years. (19th August 2022)

• Record Type: Journal Article
• Authors: Hashi, A; Gutale, A; Elnour, A; Madhavan, A; Singh, P; Preston, SR; Abbassi-Ghadi, N
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 6
• Publication Date: 2022-08-19
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac269.216
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aim: To present modern day outcomes for Boerhaave's in a single tertiary oesophago-gastric centre. Method: This study retrospectively analysed the records of consecutive patients diagnosed with Boerhaave's between June 2016 and June 2021. Results: In this case series (n=18) patients were included, male (n=14) and female (n=4), with a mean age of 61. Treatment was commenced within 24 hours of symptom onset in (n= 7;38.8%), and after (n=11; 61.1%). All Patients had an OGD performed on arrival in theatre to plan operative management. The site of the oesophageal perforation was identified as: distal third (n=14;77.8%); middle third (n=4;22.2%). Majority of patients were treated surgically (61.11%), with only seven non operatively. Within the surgical group the most common operative technique was primary repair over T-tube with intercostal drains via Thoracotomy (n=8;72.72%), followed by a trans-hiatal primary repair via a laparotomy (n=2;18.18%) or laparoscopy (n=1;9.1%). There were three major complications requiring unplanned return to theatre. One patient required a redo-thoracotomy, decortication, and evacuation of an empyema. One patient had a consistent leak post primary repair from oesophageal perforation requiring Eso-sponge vacuum therapy for further healing and closure of the tear. Another patient required a revision of feeding Jejunostomy. There was zero mortality both in hospital and in 30- and 90-days following admission. The average hospital stay was 34 days, of which 11 days was in Intensive care. Conclusion: With this data, we can conclude that aggressive medical management coupled with surgical management as well as mediastinal debridement and washout resulted in no mortality.