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J Thorac Cardiovasc Surg 2001;121:0178-0179
© 2001 The American Association for Thoracic Surgery

Brief Communications

Thoracoscopic repair of a spontaneous perforation of the esophagus with the endoscopic suturing device

Yoshifumi Ikeda, MD, Masanori Niimi, MD, PhD, Yuzo Sasaki, MD, Tomoo Shatari, MD, Hiroshi Takami, MD, Susumu Kodaira, MD, Tokyo, Japan

From the First Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.

Received for publication May 23, 2000. Accepted for publication May 27, 2000. Address for reprints: Yoshifumi Ikeda, First Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan (E-mail: yikeda@med.teikyo-u.ac.jp).

Spontaneous perforation of the esophagus (Boerhaave's syndrome) is a life-threatening condition demanding early diagnosis and effective treatment to prevent fulminant mediastinitis and death. Primary closure and wide drainage of the mediastinum is generally accepted as the treatment of choice within the first 24 hours of spontaneous perforation of the esophagus.Go Go 1,2 Although minimal access surgery with endoscopy has recently received much attention in various surgical procedures, only 1 case of thoracoscopic repair of transmural rupture of the esophagus has been reported.Go 3 In this case, the repair was performed with standard free-needle suturing, but a leak occurred after the operation. We report the first successful case of thoracoscopic repair of a spontaneous ruputure of the esophagus with the use of the Endo Stitch loading unit (Auto Suture Company, Division of United States Surgical Corporation, Norwalk, Conn).

Clinical summary
A 39-year-old man was admitted 12 hours after forceful vomiting following alcohol consumption. He had progressive chest pain that was sharp and radiated to the back. He was unable to lie . . . [Full Text of this Article]






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