Endoscopic Treatment versus Surgical Repair of Esophageal Perforation: A Systematic Review. | ||||
| Ain Shams Journal of Surgery | ||||
| Volume 18, Issue 3, July 2025, Page 163-168 PDF (961.76 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/asjs.2024.277451.1136 | ||||
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| Authors | ||||
Mena Saad Allah Lokas Yosab  ; Ahmed M. Farrag ; Hisham El-Akkad; Tarek Abouzeid Osman
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| Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt | ||||
| Abstract | ||||
| Introduction: Esophageal perforation (EP) is considered a potentially fatal condition. The main causes are iatrogenic, spontaneous, foreign body (FB) ingestion, traumatic, and malignant. Treatment of choice is conventional due to different modalities available conservative treatment, surgical repair, and endoscopic treatment. While surgical repair has traditionally been the recommended treatment for EP, endoscopic treatment is becoming on the rise. Aim of work: To provide cumulative data about the efficacy and safety of endoscopic treatment versus surgical repair of EP. Patients and methods: This systematic review with meta-analysis was conducted at the Upper GIT Surgery Department, Faculty of medicine, Ain Shams University. This is a systematic review of literatures published in the recent ten years and prepared carefully to follow the Cochrane Handbook for Systematic Reviews of Interventions. Results: Ten studies met the inclusion criteria with a total of 1452 patients (707 men, 728 women; mean age 66.5 years). The most common etiology was spontaneous (36.8%), followed by iatrogenic cause (21%), and the most common location was middle part (47%). Endoscopic treatment and surgical repair were done in 871, 581 patients respectively. The overall mean age was 66.5 years. There was a statistically significant higher complication (P=0.015) and longer length of hospital stay (P=0.008) in the surgical repair. Regarding mortality rate and failure of treatment, there was statistically insignificant difference among two groups (P=0.042) and (P=0.45). Conclusion: Surgical repair of EP was associated with more complications and longer hospital stay than the endoscopic treatment. Neither is superior, in lowering the mortality rate and treatment failure. | ||||
| Keywords | ||||
| Endoscopic treatment; surgical repair; esophageal perforation; Boerhaave syndrome | ||||
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