NEW APPROACH TO SURGICAL-MANAGEMENT OF EARLY ESOPHAGEAL THORACIC PERFORATION - PRIMARY SUTURE REPAIR REINFORCED WITH ABSORBABLE MESH AND FIBRIN GLUE

Esophageal perforation is a life-threatening situation and represents a major therapeutic challenge. Results have improved in recent years p articularly as a result of progress in antibiotic therapy and the use of total parenteral nutrition. Surgical management retains a predomina nt role, involving early primary closure and thoracic drainage. We hav e made an addition to the surgical management by applying an absorbabl e mesh and fibrin glue to the repaired site. Seven patients (ages 38-7 9 years) were treated as described. The mean interval from Leak to sur gery was 28 hours. Six patients had an uneventful postoperative course with a mean hospital stay of 34 days (range 26-45 days). In one case the technique failed and the patient required an exclusion-diversion p rocedure. All 7 patients recovered without mortality. We believe that this technique provides a real improvement for this precarious esophag eal repair.