Ulus Travma Acil Cerrahi Derg. 2010; 16(6): 511-515

Geç servikal özofajiyal perforasyonun tedavisi

Ming Chen, Yi Lin, Beibei Yang
Zhejiang Týp Fakültesi, Ýkinci Hastanesi, Kulak Burun Boðaz Kliniði, Zhejiang, Çin Halk Cumhuriyeti.

AMAÇ
Servikal özofagusun geç perforasyonu tedavisine yönelik farklý yöntemler belirlemeyi amaçladýk.
GEREÇ VE YÖNTEM
Yabancý cisim nedenli 10 adet geç servikal özofajiyal perforasyon olgusu incelendi. Olgular, tanýlarýna ve tedavilerine göre üç gruba bölündü. Grup I: Servikal apseli olgular; bu hastalar daha sonra servikal insizyonla drene edildi ve primer olarak tamir edildi, Grup II: Servikal apseli olgular; bu hastalar daha sonra servikal insizyonla drene edildi ve yabancý cisim granülomu olan apseler çýkartýldý ve Grup III. Yabancý cisimler çýkartýldý. Bütün olgulara geniþ spektrumlu antibiyotikler verildi ve oral yolla herhangi bir gýda almalarý bir hasta dýþýnda kýsýtlandý.
BULGULAR
Bütün hastalar mortalite gerçekleþmeksizin düzeldi ve normal yutma fonksiyonu korundu. Her gruptaki tedavi zamaný farklý idi.
SONUÇ
Yabancý cismin çýkartýlmasýnda, oral yolla gýda alýmýnýn yasaklanmasý ve geniþ spektrumlu antibiyotikler verilmesini içeren konservatif tedavi uygundur. Apse ile birlikte olan perforasyonlar, strip kas flep tamiri ve irrigasyon drenajý ile bir arada uygulanan debridman yoluyla cerrahi olarak tedavi edilebilir. Granüloma daha sonra servikal insizyon ve vakum drenaj ile çýkartýlabilir.

Anahtar Kelimeler: Özofajiyal perforasyon, geç servikal tedavi; primer tamir.

---

Management of late cervical esophageal perforation

Ming Chen, Yi Lin, Beibei Yang
Department Of Otolaryngology, Second Affiliated Hospital Of Medical School, Zhejiang University, China

BACKGROUND
We aimed to identify different methods of treating late perforation of the cervical esophagus.
METHODS
Ten late cervical esophageal perforations were caused by foreign bodies. The subjects were divided into three groups according to their diagnosis and treatment as follows: Group I: Cases with cervical abscess were drained by lateral cervical incision and primarily repaired, Group II: Cases with cervical abscess were drained by lateral cervical incision, and any foreign body granulomas found were removed, and Group III: Foreign bodies were removed. All cases were given broad-spectrum antibiotics and were prohibited from any oral food, except Case 5.
RESULTS
All patients recovered without mortality and retained normal swallow function. The time for treatment in each group was different.
CONCLUSION
The conservative management of removal of foreign body, prohibition of oral food and administration of broad-spectrum antibiotics is supported. Perforations with the presence of abscess can be surgically treated by debridement closure combined with strip muscle flap repair and irrigation drainage. Granuloma can be removed by lateral cervical incision and vacuum sealing drainage.

Keywords: Esophageal perforation, late cervical management; primary repair.

---

ATIF KOPYALA