{"title":"内镜支架置入术治疗布尔哈夫综合征。","authors":"Piyush Manoria","doi":"10.1177/00031348251338379","DOIUrl":null,"url":null,"abstract":"<p><p>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 (I<sup>2</sup> = 98.85%). Endoscopic stenting provided better outcomes for hospital stay duration and postoperative complications above surgical intervention, although publication bias shows a moderate risk (<i>P</i> = 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.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1355-1361"},"PeriodicalIF":0.9000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endoscopic Stenting for the Treatment of Boerhaave's Syndrome.\",\"authors\":\"Piyush Manoria\",\"doi\":\"10.1177/00031348251338379\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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 (I<sup>2</sup> = 98.85%). Endoscopic stenting provided better outcomes for hospital stay duration and postoperative complications above surgical intervention, although publication bias shows a moderate risk (<i>P</i> = 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.</p>\",\"PeriodicalId\":7782,\"journal\":{\"name\":\"American Surgeon\",\"volume\":\" \",\"pages\":\"1355-1361\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Surgeon\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00031348251338379\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Surgeon","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00031348251338379","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
自发性食道破裂,称为布尔哈夫综合征,是一种严重的医疗状况,除非提供适当的紧急医疗护理,否则会产生高死亡率。内窥镜支架置入术作为一种微创治疗方法,在外科手术不再受欢迎后兴起。本研究通过检查Boerhaave综合征的治疗成功率、并发症和死亡率统计数据来回顾内镜下支架置入的结果。基于PRISMA指南,对2014年至2024年从PubMed、Scopus和Web of Science获得的研究进行了系统评价。在回顾过程中,患者人口统计学、干预特征和临床结果是数据提取的主要目标。随机效应模型统计分析证实内镜下支架置入术是一种有效的治疗方法,72.4%的患者成功封闭,93%的患者成功封堵漏孔。研究方法和患者多样性的显著水平导致了高异质性(I2 = 98.85%)。尽管发表偏倚显示中等风险(P = 0.1602),但内镜支架置入在住院时间和术后并发症方面优于手术干预。随着目前研究对支架技术和患者选择方法的发展,内窥镜支架植入术中迁移的主要限制显示出改善的希望。内窥镜支架置入术作为布尔哈夫综合征患者可接受的手术选择的测试结果已经存在,但需要额外的随机试验来优化治疗程序。
Endoscopic Stenting for the Treatment of Boerhaave's Syndrome.
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.
期刊介绍:
The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.