Skip to main content
SpringerLink
Log in

The Sealing Effect of a Fibrin Tissue Patch on the Esophageal Perforation Area in Primary Repair

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to investigate the efficacy of the fibrin tissue patch and to analyze its use in patients with esophageal perforation.

Methods

We studied 28 patients who were diagnosed with esophageal perforation between January 1990 and January 2006 at Akdeniz University Hospital. Sixteen (57.14%) were male. The average age was 59 ± 9 years. We performed surgery and primary repair reinforcement even if the diagnosis of esophageal perforation was late.

Results

Twenty-three (82.14%) perforations were the result of endoscopic instruments; spontaneous perforations occurred in three (10.71%) patients. Postoperative complication (Heller myotomy) caused perforation in one patient (3.57%) and blunt trauma in one patient (3.57%). Three (10.71%) patients had cervical perforation, and 25 (89.29%) patients had thoracic esophageal perforation. Twelve (42.86%) patients underwent emergency surgery (within the first 24 h). Ten (35.71%) patients underwent surgery within 48 h, and the remaining 6 (21.43%) underwent surgery after 48 h. Nine (32.14%) patients had primary repair, 7 (25%) had reinforcement of the primary repair with fibrin tissue patch, 7 (25%) had esophagectomy and gastric pull-up, and 2 (7.14%) had drainage and placement of metallic stents. In four patients of the nine who had primary repair, fistula complication was detected, whereas in only one of the seven who had reinforcement of the primary repair with fibrin tissue patch was a fistula detected. Three patients (10.71%), two of whom had Boerhaave’s syndrome, died.

Conclusions

Surgical primary repair with fibrin tissue patch is the most successful treatment option in the management of esophageal perforation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Jones WG, Ginsberg RJ (1992) Esophageal perforation: a continuing challenge. Ann Thorac Surg 53:534–543

    Article  PubMed  Google Scholar 

  2. Port JL, Kent MS, Korst RJ, et al. (2003) Thoracic esophageal perforations: a decade of experience. Ann Thorac Surg 75:1071–1074

    Article  PubMed  Google Scholar 

  3. Brinster CJ, Singhal S, Lee L, et al. (2004) Evolving options in the management of esophageal perforation. Ann Thorac Surg 77:1475–1483

    Article  PubMed  Google Scholar 

  4. Wesdorp IC, Bartelsman JF, Huibregtse K, et al. (1984) Treatment of instrumental esophageal perforation. Gut 25:398–404

    Article  PubMed  CAS  Google Scholar 

  5. Attar S, Hankins JR, Suter CM, et al. (1990) Esophageal perforation: a therapeutic challenge. Ann Thorac Surg 50:45–51

    Article  PubMed  CAS  Google Scholar 

  6. Eroglu A, Kurkcuoglu IC, Karaoglanoglu N, et al. (2004) Esophageal perforation: the importance of early diagnosis and primary repair. Dis Esophagus 17:91–94

    Article  PubMed  Google Scholar 

  7. Bufkin BL, Miller JI Jr, Mansour KA (1996) Esophageal perforation: emphasis on management. Ann Thorac Surg 61:1447–1452

    Article  PubMed  CAS  Google Scholar 

  8. Flynn AE, Verrier ED, Way LW, et al. (1989) Esophageal perforation. Arch Surg 124:1211–1215

    PubMed  CAS  Google Scholar 

  9. Urschel HC Jr, Razzuk MA, Wood RE, et al. (1974) Improved management of esophageal perforation: exclusion and diversion in continuity. Ann Surg 179:587–591

    Article  PubMed  Google Scholar 

  10. Johnsson E, Lundell L, Liedman B (2005) Sealing of esophageal perforation or ruptures with expandable metallic stents: a prospective controlled study on treatment efficacy and limitation. Dis Esophagus 18:262–266

    Article  PubMed  CAS  Google Scholar 

  11. Kiernan PD, Sheridan MJ, Hettrick V, et al. (2006) Thoracic esophageal perforation: one surgeon’s experience. Dis Esophagus 19:24–30

    Article  PubMed  CAS  Google Scholar 

  12. Okten I, Cangır AK, Ozdemir N, et al. (2001) Management of esophageal perforation. Surg Today 31:36–39

    Article  PubMed  CAS  Google Scholar 

  13. Chao YK, Liu YH, Ko PJ, et al. (2005) Treatment of esophageal perforation in a referral center in Taiwan. Surg Today 35:828–832

    Article  PubMed  Google Scholar 

  14. Khan AA, Shah SW, Alam A, et al. (2005) Sixteen years follow up of achalasia: A prospective study of graded dilatation using Rigiflex balloon. Dis Esophagus 18:41–45

    Article  PubMed  CAS  Google Scholar 

  15. Richardson JD (2005) Management of esophageal perforations: the value of aggressive surgical treatment. Am J Surg 190:161–165

    Article  PubMed  Google Scholar 

  16. Bladergroen MR, Lowe JE, Postlethwait RW (1986) Diagnosis and recommended management of esophageal perforation and rupture. Ann Thorac Surg 42:235–239

    Article  PubMed  CAS  Google Scholar 

  17. Sung SW, Park JJ, Kim YT, et al. (2002) Surgery in thoracic esophageal perforation: primary repair is feasible. Dis Esophagus 15:204–209

    Article  PubMed  CAS  Google Scholar 

  18. Wright CD, Mathisen DJ, Wain JC, et al. (1995) Reinforced primary repair of thoracic esophageal perforation. Ann Thorac Surg 60:245–249

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

The authors thank T.M.P. Duggan for editing the manuscript. This study was supported by the Akdeniz University Research Fund.

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Akdeniz University School of Medicine, Antalya, 07070, Turkey

    Abdullah Erdogan, Gulsum Gurses, Hakan Keskin & Abid Demircan

Authors
  1. Abdullah Erdogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gulsum Gurses
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hakan Keskin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Abid Demircan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abdullah Erdogan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Erdogan, A., Gurses, G., Keskin, H. et al. The Sealing Effect of a Fibrin Tissue Patch on the Esophageal Perforation Area in Primary Repair. World J Surg 31, 2199–2203 (2007). https://doi.org/10.1007/s00268-007-9207-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-007-9207-z

Keywords

Search

Navigation