Endoscopic Stenting for the Treatment of Boerhaave's Syndrome.

Abstract

The spontaneous rupture of the esophagus, called Boerhaave's syndrome, presents a critical medical condition that produces high mortality rates unless appropriate emergency medical care is provided. Endoscopic stenting has risen as a minimally invasive treatment option after surgical procedures lost their popularity for addressing this condition. The study reviews endoscopic stenting results in Boerhaave's syndrome by examining treatment success rates and complication and mortality statistics. A systematic review based on the PRISMA guidelines that included studies from 2014 to 2024 obtained from PubMed, Scopus, and Web of Science was conducted. Patient demographics, intervention characteristics, and clinical outcomes were the primary targets for data extraction during the review process. A random-effects model statistical analysis confirmed endoscopic stenting as an effective treatment, achieving closure success in 72.4% of patients and leak occlusion in 93% of cases. A significant level of study methodological and patient diversity caused high heterogeneity (I² = 98.85%). Endoscopic stenting provided better outcomes for hospital stay duration and postoperative complications above surgical intervention, although publication bias shows a moderate risk (P = 0.1602). The major limitation related to migration in endoscopic stenting shows promise for improvement as current research develops both stent technology and patient selection methods. Testing outcomes from endoscopic stenting as an acceptable surgical option for Boerhaave's syndrome patients exists, but additional randomized trials need to optimize treatment procedures.