Document Detail


Esophagus perforation complicating anterior cervical spine surgery.
MedLine Citation:
PMID:  21874293     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To study the diagnosis and treatment strategy of esophagus perforation complicating anterior cervical spine surgery.
METHODS: From 2000 to 2010, we performed 1,045 cases of anterior cervical surgeries. One developed esophagus perforation. The diagnosis and treatment strategy of this case and the other five patients with esophagus perforation from other hospitals were retrospectively reviewed. For an intraoperative perforation, primary double layer suture was performed. Postoperatively, the patient took nutrition by a nasogastric tube instead of oral intake for one week. For three cases of perforations early in the post-operative period, oral intake was forbidden and nasogastric tube was conducted for nutrition support. The wound was debrided and open drainage was conducted postoperatively. Intravenous broad-spectrum antibiotic therapy was utilized. For perforations at postoperative year 3 and 7, prohibition of oral intake, intravenous broad-spectrum antibiotics therapy, and nasogastric tube nutrition support were all conducted and surgical debridement was performed. In operation, fixation plates and screws were removed, and the edges of the perforation were loosely approximated by synthetic absorbable sutures. Postoperatively, skin wound was kept open for drainage.
RESULTS: All the perforations healed evenly without secondary complications.
CONCLUSIONS: When a perforation is suspected, imaging techniques should be employed. Surgical treatment facilitates the healing of esophagus perforation. Supportive treatments including prohibition of oral intake, intravenous broad-spectrum antibiotic therapy, feeding with a nasogastric tube were mandatory parts of treatments.
Authors:
Xuhua Lu; Qunfeng Guo; Bin Ni
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Publication Detail:
Type:  Journal Article     Date:  2011-08-27
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  21     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-06     Completed Date:  2012-09-24     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  172-7     Citation Subset:  IM    
Affiliation:
Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, People's Republic of China. xuhualu@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cervical Vertebrae / surgery*
Esophageal Perforation / etiology*,  radiography,  surgery
Esophagus / injuries*,  surgery
Female
Humans
Intraoperative Complications / etiology*,  radiography,  surgery
Male
Middle Aged
Retrospective Studies
Spinal Fractures / surgery*
Spinal Fusion / adverse effects*,  methods
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