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Surgical management experience of esophageal perforation
Surgical management experience of esophageal perforation
Iran Moreno-Martínez 1 
, José M.C. Segura-González 1 , Ángel A. García-León 1, Álvaro J. Montiel-Jarquín 2 , José A. Parra-Salazar 3, Angélica Porras-Juárez 4, Arturo García-Galicia 5 , Nancy R. Bertado-Ramírez 5 , Roberto Ramírez-Serrano 4
1 Departamento de Cirugía General, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; 2 Dirección de Educación e Investigación en Salud, Centro Médico Nacional Gral. de Div. Manuel Ávila Camacho, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social (IMSS) Puebla, México; 3 Dirección General, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; 4 Dirección de Educación e Investigación en Salud, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; 5 Unidad Médica de Alta Especialidad Hospital de Especialidades de Puebla, Dirección de Educación e Investigación en Salud, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS). Puebla, México
*Correspondence: Álvaro J. Montiel-Jarquín. Email: alvaro.montielj@imss.gob.mx
Abstract
Background: Esophageal perforation has a high mortality rate. Surgery ranks number one in its management, but there are no standardized guidelines for decision making as to which treatment to choose.
Objective: To know the experience in the management of esophageal perforation in a tertiary care hospital.
Material and methods: Descriptive study of patients diagnosed with esophageal perforation in our hospital from January 2021 to March 2024. The efficacy of management was evaluated according to the percentage of complications, reinterventions and mortality.
Results: 15 patients were studied, 8 (53.3%) males and 7 (46.7%) females. The main etiology was surgical procedures (60%). Twelve patients (80%) underwent operative intervention. The primary repair reinforced with a fundoplication being the most common surgical technique (41.66%). The relation between the type of management and mortality resulted in a p = 0.33, and between the time of diagnosis and mortality gave a result of p = 0.09.
Conclusions: The delayed diagnosis has a direct influence on the survival rate. The treatment must be adjusted to each case. Both surgery and non-operative management offer good results, but more studies are required to establish guidelines for decision-making.
Keywords: Esophageal perforation. Primary repair. Esophagus. Treatment.
