Surgical management of esophageal perforation
- Daniel P Raymond, MD
Daniel P Raymond, MD
- Thoracic Surgeon
- The Cleveland Clinic
- Carolyn Jones, MD
Carolyn Jones, MD
- Assistant Professor of Surgery
- University of Rochester
Esophageal perforation is a diagnostic and therapeutic challenge because of the rarity of the condition and the variability in presentation. Surgical management is primarily based upon small retrospective studies and expert opinion.
The following basic principles are applied to the management of a patient with an esophageal perforation:
●Appropriate hemodynamic monitoring and support
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- PRIMARY MANAGEMENT
- Initial management
- Selection of operative candidates
- PRINCIPLES OF SURGICAL MANAGEMENT
- Primary surgical repair
- - General principles for esophageal repair
- - Cervical perforation
- - Thoracic perforation
- - Abdominal perforation
- - Postoperative management
- Alternatives to primary surgical repair
- - Drainage only
- - Diversion
- - Endoscopic stent placement
- - Esophagectomy
- OUTCOMES FOLLOWING OPERATIVE MANAGEMENT
- NONOPERATIVE MANAGEMENT
- SUMMARY AND RECOMMENDATIONS