SUMMARY
Introduction. Treatment of patients with esophageal injury is one of the most difficult problems of modern surgery. Esophageal perforation is accompanied by acute purulent mediastinitis in 67 – 84 % cases.
Materials and methods. The results of treatment of 27 patients are analyzed.

Results. The causes of perforation of the esophagus were foreign bodies in 9 (33.3 %), spontaneous rupture – in 29.6 %, iatrogenic – in 18.5 %, failure of sutures after resection of the esophagus and stenting – at 18.5 %. Postoperative lethality in patients with perforation of the esophagus complicated by acute purulent mediastinitis was 37.1 % (10 out of 27 patients died). In the application of lateral thoracotomy, postoperative lethality was 50 % (9 out of 18 patients died), with video-assisted thoracoscopy 14.3 % (1 out of 7 patients died).
Conclusions. The main purpose of surgical treatment is to eliminate the purulent-inflammatory process in the mediastinum and stabilize the condition of the patients. With perforation of the esophagus, which is complicated by acute purulent mediastinitis, expanded operations on the esophagus are accompanied by high rates of postoperative lethality, Stitching of the perforation of the esophagus should be performed to distinguish the esophageal lumen from the mediastinal fluid, localization of the purulent process in the mediastinum, and to stabilize the general condition of the patient. Minimal invasive surgical interventions using video-assisted thoracoscopy can serve as a selection option in patients with perforation of the esophagus in the common forms of acute purulent mediastinitis.
Key words: perforation of the esophagus, esophageal rupture, mediastinitis.
Lek Obz, 2020, 69 (9): 298-301

Sergiy SNIZHKO, Igor SHEVCHUK, Igor SADOVIY

Ivano–Frankivsk National Medical University, Ukraine

Práca vyšla v anglickom jazyku

CITÁCIA:

Sergiy SNIZHKO, Igor SHEVCHUK, Igor SADOVIY: Liečba pacientov s perforovaným ezofágom, komplikovaným akútnou purulentnou mediastinitídou. Lek Obz, 2020, 69 (9): 298-301