Dokument: Classification of the oesophageal perforation

Titel:Classification of the oesophageal perforation
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=68231
URN (NBN):urn:nbn:de:hbz:061-20250123-123021-1
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Harrich, Friederike [Autor]
Knoefel, Wolfram Trudo [Autor]
Bölke, Edwin [Autor]
Schauer, Matthias [Autor]
Dateien:
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Dateien vom 23.01.2025 / geändert 23.01.2025
Stichwörter:Esophagus, Perforation, Classification, Esophageal surgery
Beschreibung:Objectives

Esophageal perforations are a complex clinical scenario that have been poorly studied. To date, there is no grading of esophageal perforations, the reason being that the outcome is very heterogeneous, because the perforation is very heterogeneous. A grading of the severity of the perforation may guide treatment, and could ultimately affect morbidity and mortality.
Methods

The observation period of the study was four years. All patients with a perforation of the esophagus aged 18 to 90 years were included. All anastomotic insufficiencies or fistulas after surgery of the esophagus were excluded. The cause of the injury and the time interval between the event and the start of therapy were analyzed. The severity of each perforation was classified based on the results of a diagnostic CT scan, gastroscopy as well as clinical and laboratory findings. Therapy and signs of infection were evaluated. Endpoints of the study were patient recovery or death. The study was conducted as a retrospective single-center study at a university hospital of Düsseldorf. The study has been approved by the review board. Patients gave their informed consent before data collection. All data were analyzed using SPSS 29 (IBM SPSS Statistics software).
Results

Age, gender and cause of the esophageal perforation did not impact significantly on overall survival. The duration of injury > 24 h (p = 0.01), presence of mediastinitis (p = 0.01) and necrosis of the esophagus (p = 0.02) were associated with an unfavorable outcome. The correlation of the clinical grading of the severity of the perforation based on the endoscopic, radiological and clinical findings with the overall survival of patients was significant. Patients categorized into the four grades of severity (I–IV) had an overall survival of 100%, 100%, 70% and 50%, respectively.
Conclusion

The severity of esophageal perforations can be systematically rated grades I to IV based on the radiological, endoscopic and clinical findings at diagnosis. Due to the grading and its correlation to the overall survival, a comparison of patients, their treatment and outcome becomes possible. In future, the grade of a perforation may guide treatment, and therefore affect morbidity and mortality.
Rechtliche Vermerke:Originalveröffentlichung:
Harrich, F. H. M., Knoefel, W. T., Bölke, E., & Schauer, M. (2024). Classification of the oesophageal perforation. European Journal of Medical Research, 29, Article 352. https://doi.org/10.1186/s40001-024-01910-8
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:23.01.2025
Dateien geändert am:23.01.2025
english
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