Your browser doesn't support javascript.
loading
Esophageal perforation after anterior cervical spine surgery.
Salami, Aitua C; Rao, Madhuri; Berger, Jonathan; Diaz-Gutierrez, Ilitch; Khariwala, Samir S; Khaja, Sobia F; Sembrano, Jonathan N; Hunt, Matthew; Andrade, Rafael; Bhargava, Amit.
Afiliación
  • Salami AC; Division of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minn.
  • Rao M; Division of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minn.
  • Berger J; Division of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minn.
  • Diaz-Gutierrez I; Division of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minn.
  • Khariwala SS; Department of Otolaryngology, Head, and Neck Surgery, University of Minnesota, Minneapolis, Minn.
  • Khaja SF; Department of Otolaryngology, Head, and Neck Surgery, University of Minnesota, Minneapolis, Minn.
  • Sembrano JN; Department of Orthopedics, University of Minnesota, Minneapolis, Minn.
  • Hunt M; Department of Neurosurgery, University of Minnesota, Minneapolis, Minn.
  • Andrade R; Division of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minn.
  • Bhargava A; Division of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minn.
JTCVS Tech ; 25: 208-213, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38899091
ABSTRACT

Objective:

To report our updated experience in the management of esophageal perforation resulting from anterior cervical spine surgery, and to compare two wound management approaches.

Methods:

This is a retrospective review of patients managed for esophageal perforations resulting from anterior cervical spine surgery (2007-2020). We examine outcomes based on 2 wound management approaches closed (closed incision over a drain) versus open (left open to heal by secondary intention). We collected data on demographics, operative management, resolution (resumption of oral intake), time to resolution, number of procedures needed for resolution, microbiology, length of stay, and neck morbidity.

Results:

A total of 13 patients were included (10 men). Median age was 52 years (range, 24-74 years). All patients underwent surgical drainage, repair, or attempted repair of perforation, hardware removal, and establishment of enteral access. Wounds were managed closed versus open (6 closed, 7 open). There were 2 early postoperative deaths due to acute respiratory distress syndrome and aspiration (open group), and 1 patient was lost to follow-up (closed group). Among the remaining 10 patients resolution rate was 80% versus 100%, resolution in 30 days was 20% versus 100%, median number of procedures needed for resolution was 3 versus 1, and median hospital stay was 23 versus 14 days, for the closed and open groups, respectively.

Conclusions:

Esophageal perforation following anterior cervical spine surgery should be managed in a multidisciplinary fashion with surgical neck drainage, primary repair when feasible, hardware removal, and establishment of enteral access. We advocate open neck wound management to decrease the time-to-resolution, number of procedures, and length of stay.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JTCVS Tech Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JTCVS Tech Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos