Endoscopic Vacuum Therapy for Treatment of Boerhaave's syndrome: a multicenter analysis.

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy Pub Date : 2024-08-30 DOI:10.1016/j.gie.2024.08.037

Andreas Wannhoff, Konstantinos Kouladouros, Ronald Koschny, Benjamin Walter, Zita Zoll, Karsten Büringer, Susanne Blank, Ulrike Schempf, Karel Caca, Dörte Wichmann

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引用次数: 0

Abstract

Background and aims: Boerhaave's syndrome, an effort rupture of the esophagus, is a rare but serious condition. Endoscopic vacuum therapy (EVT) is a new therapeutic approach for gastrointestinal perforation.

Methods: This retrospective study was conducted at five tertiary hospitals in southern Germany. All patients treated for Boerhaave's syndrome since 2010 were identified and included. Treatment success and outcomes were assessed and compared between the different modes of primary treatment.

Results: Fifty-seven patients with Boerhaave's syndrome were identified (median age 68 years; n = 16 female). The primary treatment was EVT in 25 cases, surgery in 14, and endoscopic stenting in 15. Primary EVT was successful in 20 of the 25 patients (80.0%). Two patients were switched to surgical treatment and one was switched to esophageal stenting and two died. The mortality rate was lower (P = 0.160) in patients treated primarily with EVT (n = 2, 8.0%) than in comparison to patients of the non-EVT group (n = 8, 25.0%). Treatment success was significantly higher (P = 0.007) for primary EVT (80.0%) than for non-EVT (43.8%). Primary EVT was associated with treatment success in multivariate analysis.

Conclusions: EVT showed a high success rate for treatment of Boerhaave's syndrome and was associated with treatment success.

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内窥镜真空疗法治疗布尔哈夫综合征：一项多中心分析。

背景和目的：Boerhaave's 综合征是一种罕见但严重的食管破裂。内镜真空疗法（EVT）是治疗胃肠道穿孔的一种新方法：这项回顾性研究在德国南部的五家三级医院进行。方法：这项回顾性研究在德国南部的五家三甲医院进行，确定并纳入了自 2010 年以来接受治疗的所有博尔哈弗综合征患者。对治疗的成功率和结果进行了评估，并对不同的初治方式进行了比较：结果：共发现 57 名布尔哈韦综合征患者（中位年龄 68 岁；n = 16 名女性）。25例患者的主要治疗方法是EVT，14例患者的主要治疗方法是手术，15例患者的主要治疗方法是内窥镜支架植入术。25 例患者中有 20 例（80.0%）的原发性 EVT 获得成功。两名患者转为手术治疗，一名转为食管支架置入术，两名患者死亡。与非 EVT 组患者（8 人，25.0%）相比，主要接受 EVT 治疗的患者（2 人，8.0%）死亡率较低（P = 0.160）。原发性 EVT（80.0%）的治疗成功率（P = 0.007）明显高于非 EVT（43.8%）。在多变量分析中，原发性EVT与治疗成功率相关：EVT治疗波尔哈韦综合征的成功率很高，并且与治疗成功率有关。

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

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.

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