A RATIONAL SURGICAL APPROACH FOR INTRATHORACIC ESOPHAGEAL-PERFORATION

The surgical experiences of intrathoracic esophageal perforation in 17 consecutive cases seen during the last eight years are reviewed. Usin g a rational approach to this critical condition, the mortality and mo rbidity rates were lower than before. For acute perforation in a corro sive-injured esophagus, subtotal esophagectomy by eversion stripping w as an effective procedure for life saving. For acute perforation of a normal or chronic fibrotic but functional esophagus, early primary rep air was usually successful for healing. For chronic esophageal perfora tion, usually complicated by mediastinal abscess or purulent pleural e ffusion, an adequate local drainage or supplemented with a newly desig ned, temporary diversion procedure for drainage of saliva and gastric acid was recommended.