[Operative treatment of non-malignant esophageal perforations - a summary of our experiences].

INTRODUCTION: Despite significant development in surgical and intensive therapy, esophageal perforation is still a severe, life-threatening condition. Successful therapy depends on several clinical factors, available medical equipments, but most of all on the available expertise and experience.

PATIENTS AND METHODS: We retrospectively evaluated patients' data operated at the 1st Department of Surgery at Semmelweis University between 2005 and 2017 due to esophageal perforation of non-malignant origin.

RESULTS: During the period above 77 patients were treated. All of them were referred to us from an external institute. 15 patients (19%) arrived in shock. The patients developed perforation in 29 cases spontaneously (38%), in 32 cases (41%) during endoscopy, in 12 cases (16%) due to food bolus impaction, and in 4 cases (5%) following balloon tamponade of esophageal variceal bleeding. Patients were sent to our clinic 2.7 days after the presentation of the symptoms. In 2 patients (2%) drainage, in 6 patients (8%) suture, in 8 patients (12%) funduplication, in 19 patients (28%) esophageal exclusion, and in 33 patients (50%) total esophageal extirpation had to be done. 27 patients (35%) died. Discussion, conclusion: Surgical treatment of esophageal injuries is basically influenced by two factors: observation time before surgery and the presence of sepsis symptoms. We have to perform radical surgery basically due to delay. Waste of time is caused by the non-uniform diagnostic strategy and the delay in the true diagnosis.