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dc.contributor.authorBiancari, Fausto
dc.contributor.authorSaarnio, Juha
dc.contributor.authorMennander, Ari
dc.contributor.authorHypén, Linda
dc.contributor.authorSalminen, Paulina
dc.contributor.authorKuttila, Kari
dc.contributor.authorVictorzon, Mikael
dc.contributor.authorBöckelman, Camilla
dc.contributor.authorTarantino, Enrico
dc.contributor.authorTiffet, Olivier
dc.contributor.authorKoivukangas, Vesa
dc.contributor.authorSøreide, Jon Arne
dc.contributor.authorViste, Asgaut
dc.contributor.authorBonavina, Luigi
dc.contributor.authorVidarsdóttir, Halla
dc.contributor.authorGudbjartsson, Tomas
dc.date.accessioned2014-09-02T09:47:47Z
dc.date.available2014-09-02T09:47:47Z
dc.date.issued2014-04
dc.date.submitted2014
dc.identifier.citationWorld J Surg. 2014, 38 (4):902-9en
dc.identifier.issn1432-2323
dc.identifier.pmid24174169
dc.identifier.doi10.1007/s00268-013-2312-2
dc.identifier.urihttp://hdl.handle.net/2336/325643
dc.descriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the pageen
dc.description.abstractRecent studies have suggested that stent-grafting may improve the treatment outcome of patients with esophageal perforation, but evidence on this is still lacking.
dc.description.abstractData on 194 patients who underwent conservative (43 patients), endoclip (4 patients) stent-grafting (63 patients) or surgical treatment (84 patients) for esophageal perforation were retrieved from nine medical centers.
dc.description.abstractIn-hospital/30-day mortality was 17.5 %. Three-year survival was 67.1 %. Age, coronary artery disease, and esophageal malignancy were independent predictors of early mortality. Chi squared automatic interaction detection analysis showed that patients without coronary artery disease, without esophageal malignancy and younger than 70 years had the lowest early mortality (4.1 %). Surgery was associated with slightly lower early mortality (conservative 23.3, endoclips 25.0 %, stent-grafting 19.0 %, surgery 13.1 %; p = 0.499). One center reported a series of more than 20 patients treated with stent-grafting which achieved an early mortality of 7.7 % (2/26 patients). Stent-grafting was associated with better survival with salvaged esophagus (conservative 76.7 %, endoclips 75.0 %, stent-grafting 77.8 %, surgery 56.0 %; p = 0.019). Propensity score adjusted analysis showed that stent-grafting achieved similar early mortality (p = 0.946), but significantly higher survival with salvaged esophagus than with surgical treatment (p = 0.001, OR 0.253, 95 % CI 0.110-0.585). Primary surgical repair was associated with somewhat lower early mortality (14.6 vs. 19.0 %; p = 0.561) and better survival with salvaged esophagus (85.4 vs. 77.8 %; p = 0.337) than stent-grafting.
dc.description.abstractEsophageal perforation was associated with a rather high mortality rate in this all-comers population. Stent-grafting failed to decrease operative mortality, but it improved survival with salvaged esophagus. The results of one of the centers indicate that increasing experience with this less invasive procedure may possibly improve the outcome of these patients.
dc.language.isoenen
dc.publisherSpringeren
dc.relation.urlhttp://dx.doi.org/10.1007/s00268-013-2312-2en
dc.relation.urlhttp://download.springer.com/static/pdf/907/art%253A10.1007%252Fs00268-013-2312-2.pdf?auth66=1409822988_e3ee78903e10fd5f7493678424c8e39b&ext=.pdf#page=1&zoom=auto,-82,791en
dc.rightsArchived with thanks to World journal of surgeryen
dc.subjectVélindaen
dc.subjectSkurðlækningaren
dc.subjectDánartíðnien
dc.subject.meshEsophageal Perforation/mortalityen
dc.subject.meshStents*en
dc.subject.meshTreatment Outcomeen
dc.subject.meshEsophageal Perforation/surgery*en
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshChilden
dc.subject.meshEsophagus/surgery*en
dc.subject.meshFemaleen
dc.subject.meshHospital Mortalityen
dc.subject.meshHumansen
dc.subject.meshIntention to Treat Analysisen
dc.subject.meshKaplan-Meier Estimateen
dc.subject.meshLogistic Modelsen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshPropensity Scoreen
dc.subject.meshProportional Hazards Modelsen
dc.subject.meshRetrospective Studiesen
dc.subject.meshYoung Adulten
dc.titleOutcome of patients with esophageal perforations: a multicenter study.en
dc.typeArticleen
dc.contributor.departmentOulu Univ Hosp, Dept Surg, Oulu 90029, Finland, Tampere Univ Hosp, Ctr Heart, Tampere, Finland, Turku Univ Hosp, Dept Surg, FIN-20520 Turku, Finland, Turku Univ Hosp, Ctr Heart, FIN-20520 Turku, Finland, Vaasa Centra Hosp, Dept Surg, Vaasa, Finland, CHU St Etienne, Hop Nord, Unite Chirurg Gen & Thorac, St Etienne, France, Stavanger Univ Hosp, Dept Surg Gastroenterol, Stavanger, Norway, Univ Bergen, Dept Clin Med, Bergen, Norway, Haukeland Hosp, Dept Clin Med, Dept Surg Gastroenterol, N-5021 Bergen, Norway, Univ Milan, IRCCS Policlin San Donato, Dept Surg, Milan, Italy, Univ Iceland, Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Icelanden
dc.identifier.journalWorld journal of surgeryen
dc.rights.accessNational Consortium - Landsaðganguren
html.description.abstractRecent studies have suggested that stent-grafting may improve the treatment outcome of patients with esophageal perforation, but evidence on this is still lacking.
html.description.abstractData on 194 patients who underwent conservative (43 patients), endoclip (4 patients) stent-grafting (63 patients) or surgical treatment (84 patients) for esophageal perforation were retrieved from nine medical centers.
html.description.abstractIn-hospital/30-day mortality was 17.5 %. Three-year survival was 67.1 %. Age, coronary artery disease, and esophageal malignancy were independent predictors of early mortality. Chi squared automatic interaction detection analysis showed that patients without coronary artery disease, without esophageal malignancy and younger than 70 years had the lowest early mortality (4.1 %). Surgery was associated with slightly lower early mortality (conservative 23.3, endoclips 25.0 %, stent-grafting 19.0 %, surgery 13.1 %; p = 0.499). One center reported a series of more than 20 patients treated with stent-grafting which achieved an early mortality of 7.7 % (2/26 patients). Stent-grafting was associated with better survival with salvaged esophagus (conservative 76.7 %, endoclips 75.0 %, stent-grafting 77.8 %, surgery 56.0 %; p = 0.019). Propensity score adjusted analysis showed that stent-grafting achieved similar early mortality (p = 0.946), but significantly higher survival with salvaged esophagus than with surgical treatment (p = 0.001, OR 0.253, 95 % CI 0.110-0.585). Primary surgical repair was associated with somewhat lower early mortality (14.6 vs. 19.0 %; p = 0.561) and better survival with salvaged esophagus (85.4 vs. 77.8 %; p = 0.337) than stent-grafting.
html.description.abstractEsophageal perforation was associated with a rather high mortality rate in this all-comers population. Stent-grafting failed to decrease operative mortality, but it improved survival with salvaged esophagus. The results of one of the centers indicate that increasing experience with this less invasive procedure may possibly improve the outcome of these patients.


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