627.左胸腔镜下食管穿孔初级修补术(继发于布尔哈韦综合征

IF 2.3 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Aung Myint Oo, Charleen Yeo, Ryan Jun-Yi Tan
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引用次数: 0

摘要

背景 随着微创外科技术的发展,越来越多的急性外科病症(包括食管穿孔)可以通过微创手术方法安全地进行治疗。方法 一名中年男性患者因上腹疼痛和呕吐 3 天来我科就诊。入院时他发热,检查发现他因 Boerhaave 综合征导致左侧食管穿孔,并伴有左侧胸腔积液。他成功接受了左胸腔镜食管穿孔初级修补术和冲洗术。这是胸腔镜下食管穿孔初级修补术的视频。患者取右侧卧位,通过仔细剥离胸膜确定穿孔区域,并分两层进行修补。用温生理盐水冲洗胸膜腔,插入水下密封胸管引流。结果 术后患者被转入外科重症监护室治疗 1 天。患者口服肠外营养液 7 天。术后第 7 天进行了造影检查,在没有渗漏迹象后开始口服营养液。患者康复出院。结论 对继发于波尔哈韦综合征的自发性食管穿孔进行胸腔镜初级修补冲洗术具有挑战性,但它是安全的,可以成功实施。https://drive.google.com/file/d/1JTfJLV-ngUBwzMybGV4FL8EEQB-ysj9O/view。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
627. LEFT THORACOSCOPIC PRIMARY REPAIR OF ESOPHAGEAL PERFORATION SECONDARY TO BOERHAAVE SYNDROME
Background With the advancement of the minimally invasive surgical techniques, more and more acute surgical conditions including esophageal perforations can be performed safely using minimally invasive surgical approach. Methods A middle aged male patient presented to our department with 3 days history of epigastric pain and vomiting. He was febrile on admission and investigation revealed the left sided esophageal perforation due to Boerhaave Syndrome with left sided pleural effusion. He underwent left thoracoscopic primary repair of esophageal perforation and wash out successfully. This is the video of the thoracoscopic primary repair of the perforation. Patient was put in the right lateral semi prone position, the area of perforation was identified by careful dissection of the pleura and repaired was performed in 2 layers. The pleura cavity was washed out with warm saline and underwater sealed chest tube drain was inserted. Results Post operatively patient was transferred to surgical intensive care unit for 1 day. Patient was kept nil by mouth with parenteral nutrition for 7 days. Contrast study was performed on post operative day 7 and started oral feeding when there was no evidence of leakage. Patient recovered and discharged well. Conclusion Thoracoscopic primary repair with wash out of spontaneous esophageal perforation secondary to Boerrhave Syndrome is challenging however it is safe and can be performed successfully. https://drive.google.com/file/d/1JTfJLV-ngUBwzMybGV4FL8EEQB-ysj9O/view
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来源期刊
Diseases of the Esophagus
Diseases of the Esophagus 医学-胃肠肝病学
CiteScore
5.30
自引率
7.70%
发文量
568
审稿时长
6 months
期刊介绍: Diseases of the Esophagus covers all aspects of the esophagus - etiology, investigation and diagnosis, and both medical and surgical treatment.
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