Current approach for Boerhaaves syndrome:A systematic review of case reports  

作　　者：Ippei Yamana Takahisa Fujikawa Yuichiro Kawamura Suguru Hasegawa 

机构地区：[1]Department of Surgery,Kokura Memorial Hospital,Kitakyushu,Fukuoka 802-8555,Japan [2]Department of Gastroenterological Surgery,Fukuoka University School of Medicine,Fukuoka 814-0180,Japan

出　　处：《World Journal of Meta-Analysis》2023年第4期112-124,共13页世界荟萃分析杂志

摘　　要：There is no consensus on the appropriate therapeutic strategy for Boerhaave syndrome due to its rarity and changing therapeutic approaches.We conducted a systematic review of case reports documenting Boerhaave syndrome.AIM To assess the therapeutic methods and clinical outcomes and discuss the current trends in the management of Boerhaave syndrome.METHODS We searched PubMed,Google scholar,MEDLINE,and The Cochrane Library for studies concerning Boerhaave syndrome published between 2017 and 2022.RESULTS Of the included studies,49 were case reports,including a total of 56 cases.The mean age was 55.8±16 years old.Initial conservative treatment was performed in 25 cases,while operation was performed in 31 cases.The rate of conservative treatment was significantly higher than that of operation in cases of shock vital on admission(9.7%vs 44.0%;P=0.005).Seventeen out of 25 conservative cases(68.0%)were initially treated endoscopic esophageal stenting;2 of those 17 cases subsequently underwent operation due to poor infection control.Twelve cases developed postoperative leakage(38.7%),and 4 of those 12 cases underwent endoscopic esophageal stenting to stop the leakage.The length of the hospital stay was not significantly different between the conservative treatment and operation cases(operation vs conservation:33.52±22.69 vs 38.81±35.28 days;P=0.553).CONCLUSION In the treatment of Boerhaave syndrome,it is most important to diagnose the issue immediately.Primary repair with reinforcement is the gold-standard procedure.The indication of endoscopic esophageal stenting or endoluminal vacuum-assisted therapy should always be considered for patients in a poor general condition and who continue to have leakage after repair.

关 键 词：Boerhaave syndrome Esophageal perforation Self expandable metalic stent Minimally invasive surgical procedures Anastomotic leakage Shock 

分 类 号：R57[医药卫生—消化系统]