1. [Endoscopic vacuum therapy in minimally invasive treatment of esophageal perforations].
- Author
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Gasanov MA, Danielyan SN, Chernousov FA, Gasanov AM, Rabadanov KM, Tatarinova EV, Barmina TG, Titova GP, and Nevdah SK
- Subjects
- Humans, Endoscopy, Esophageal Perforation diagnosis, Esophageal Perforation etiology, Esophageal Perforation surgery, Negative-Pressure Wound Therapy, Abdominal Injuries, Esophageal Fistula
- Abstract
Objective: To compare the results of endoscopic vacuum therapy (EVT) and open surgery for esophageal perforations., Material and Methods: The study included 60 patients with esophageal perforations between 2010 and 2022. The main group included 29 patients who underwent minimally invasive treatment with EVT, the control group - 31 patients after open surgical interventions., Results: Pneumonia occurred in 21 (72%) and 14 (45%) patients ( p =0.04), esophageal stenosis within the perforation zone - in 4 (13.8%) and 1 (3.2%) patient, respectively ( p =0.188). Chronic esophageal fistulas were significantly more common in the control group (6 (20.7%) versus 15 (48.4%) patients, p =0.032). The overall duration of treatment (median) among survivors was significantly shorter in the main group: 33 (23; 48) versus 71.5 (59; 93.7) days ( p =0.5). However, length of ICU-stay was slightly higher (11 (6; 16) versus 8.5 (5; 12.75) days, p =0.32). Mortality rate was 13.8% ( n =4) and 29% ( n =9), respectively ( p =0.213). Minimally invasive technologies decreased the risk of fatal outcome by 10 times (OR 10.123, 95% CI 1.491-124.97, p =0.035) compared to traditional surgery., Conclusion: EVT in complex minimally invasive treatment of patients with mechanical esophageal injuries is an effective method significantly reducing mortality and duration of inpatient treatment compared to traditional surgical approach.
- Published
- 2024
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