[Endoscopic vacuum therapy in minimally invasive treatment of esophageal perforations].

Q4 Medicine Khirurgiya Pub Date : 2024-01-01 DOI:10.17116/hirurgia202401121

M A Gasanov, Sh N Danielyan, F A Chernousov, A M Gasanov, K M Rabadanov, E V Tatarinova, T G Barmina, G P Titova, S K Nevdah

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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.

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[内窥镜真空疗法在食道穿孔微创治疗中的应用]。

目的：比较内窥镜真空治疗（EVT）和开放手术治疗食管穿孔的效果：比较内镜真空疗法（EVT）和开放手术治疗食管穿孔的效果：研究纳入了2010年至2022年间的60例食管穿孔患者。主要研究组包括29名接受EVT微创治疗的患者，对照组为31名接受开放手术治疗的患者：分别有21名（72%）和14名（45%）患者出现肺炎（P=0.04），4名（13.8%）和1名（3.2%）患者出现穿孔区食管狭窄（P=0.188）。慢性食管瘘在对照组中明显更常见（6 例（20.7%）对 15 例（48.4%），P=0.032）。幸存者的总体治疗时间（中位数）明显短于对照组：33（23；48）天对 71.5（59；93.7）天（P=0.5）。不过，重症监护室的停留时间略高（11 (6; 16) 天对 8.5 (5; 12.75) 天，P=0.32）。死亡率分别为13.8%（4人）和29%（9人）（P=0.213）。与传统手术相比，微创技术将死亡风险降低了10倍（OR 10.123，95% CI 1.491-124.97，P=0.035）：结论：与传统手术方法相比，EVT 在食管机械损伤患者的复杂微创治疗中是一种有效的方法，可显著降低死亡率并缩短住院治疗时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Khirurgiya Medicine-Medicine (all)

CiteScore

0.70

自引率

0.00%

发文量

161

期刊介绍： Хирургия отдельных областей сердце, сосуды легкие пищевод молочная железа желудок и двенадцатиперстная кишка кишечник желчевыводящие пути печень