Universität zu Köln

Herbold, Till, Chon, Seung-Hun ORCID: 0000-0002-8923-6428, Grimminger, Peter, Maus, Martin K. H., Schmidt, Henner, Fuchs, Hans, Brinkmann, Sebastian, Bludau, Marc, Gutschow, Christian, Schroeder, Wolfgang, Hoelscher, Arnulf H. and Leers, Jessica M. (2018). Endoscopic Treatment of Transesophageal Echocardiography-Induced Esophageal Perforation. J. Laparoendosc. Adv. Surg. Tech., 28 (4). S. 422 - 429. NEW ROCHELLE: MARY ANN LIEBERT, INC. ISSN 1557-9034

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Abstract

Background: Perforation of the esophagus is the most severe complication of transesophageal echocardiography (TEE) and can lead to mediastinitis, pleural empyema, or peritonitis. Currently, the majority of patients receive operative treatment with only 6% treated endoscopically. We report our experience with endoscopic and conservative approaches. Methods: We retrospectively reviewed all patients treated for esophageal perforation and included all patients with perforation caused by TEE. All patients with perforation of the esophagus by TEE probe underwent conservative or endoscopic treatment, drainage of pleural and mediastinal retentions, and adjusted to antibiotic therapy. Results: From January 2004 to December 2014 a total of 109 patients were treated for esophageal perforation in our department. In 6 patients (5.5%) the perforation was caused by TEE. Location was cervical and midthoracic in 2 and 4 cases, respectively. All patients underwent successful endoscopic treatment and no further surgical procedure, such as esophageal suture or resection was necessary. The mean time between TEE and therapy of the perforation was 7.3 days. In all patients closure of the leakage could be achieved within 30 days. Mortality rate was 0%. Conclusions: Esophageal perforations caused by TEE are typically small, in the cervical and mid esophagus, and minimally contaminated. These are good prognostic factors for successful endoscopic treatment with preservation of the esophagus. Operative treatment should only be considered in cases of failed endoscopic treatment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herbold, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED Grimminger, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Martin K. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Henner UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinkmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Gutschow, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, Jessica M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-198910
DOI:	10.1089/lap.2017.0559
Journal or Publication Title:	J. Laparoendosc. Adv. Surg. Tech.
Volume:	28
Number:	4
Page Range:	S. 422 - 429
Date:	2018
Publisher:	MARY ANN LIEBERT, INC
Place of Publication:	NEW ROCHELLE
ISSN:	1557-9034
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VACUUM-ASSISTED CLOSURE; CASE SERIES; MANAGEMENT; COMPLICATIONS; STENT; LEAKS; DIAGNOSIS; EFFICACY; THERAPY; OPTIONS Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19891