TY - CHAP M1 - Book, Section TI - Techniques and Indications for Esophageal Exclusion A1 - Paul, Subroto A1 - Zellos, Lambros A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Colson, Yolonda L. A2 - Jaklitsch, Michael T. A2 - Krasna, Mark J. A2 - Mentzer, Steven J. A2 - Williams, Marcia A2 - Adams, Ann PY - 2015 T2 - Adult Chest Surgery, 2e AB - The four main causes of esophageal perforation are spontaneous perforation associated with protracted vomiting, also known as Boerhaave syndrome, iatrogenic injury from instrumentation, breakdown of esophageal reconstructions after esophagectomy, and penetrating trauma.1-4 Regardless of the etiology, mediastinal contamination from salivary, gastric, and biliary secretions, with the associated bacteria, leads to both local and systemic inflammatory responses. If the perforation is not controlled promptly, it will give rise to sepsis, which if left untreated, nearly 100% of the time, will result in mortality within 1 week.1,4,5 Despite advances in surgical technique and critical care over the past decades, esophageal perforation remains a challenging clinical problem. Early diagnosis and prompt surgical treatment are the hallmarks of successful outcome after spontaneous (i.e., Boerhaave syndrome) and iatrogenic esophageal perforation. Advocates for stenting, primary esophageal repair, drainage with a T-tube, esophageal exclusion, esophageal diversion, and esophagectomy with upfront reconstruction for perforations can be found. This chapter describes the techniques and indications for esophageal exclusion. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/16 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105839568 ER -