Amer Bilal, Abdul Baseer, Muhammad Imran.
Primary Repair of Oesophageal Perforation, an Experience of 64 cases.
Esculapio J Services Inst Med Sci Jan ;15(2):158-61.

Objective: To assess the outcome of primary repair of Oesophageal Perforation Methods: Sixty four patients who underwent primary repair of Oesophageal perforation from June 2002 to May 2016 were retrospectively analyzed. Patients of all ages, both sexes and benign thoracic oesophageal perforation were included. Patients were admitted through emergency department as a referred case .Contrast study was done after stabilization. Right thoracotomy done for upper and mid-level thoracic esophageal perforation whereas left thoracotomy was done for lower end thoracic esophageal perforation. Contrast study was done on 7thpost operative day. Six months follow- up was done in all cases. Variables measured were postoperative leakage, stricture formation, morbidity and mortality. Results: Out of 64 patients, male to female ratio was 2:1, age ranges from12 to 65 years with a median age of 38 years. Perforation was caused by iatrogenic instrumentation in 49 patients, trauma in 9and ingested foreign bodies in 6. In all patients initial chest x ray was done, location of perforation was confirmed by gastrograffin study involving upper third thoracic esophagus in 14 cases , middle third 21 and lower third in 29 cases. Morbidity was 11/64 (17.18%) and mortality was 4/64 (6.25%). At 6 months follow-up, all 56 surviving patients were able to eat a normal diet. Conclusions: Primary repair and tissue reinforcement of benign esophageal perforation is safe in early cases and obviates the need for a second operation, while preserving the natural GI tract.

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