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Ann Thorac Surg 1995;60:248-249
© 1995 The Society of Thoracic Surgeons

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Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 245.

DR DAVID J. SUGARBAKER (Boston, MA): I would like to ask Dr Wright a question, and comment first on a very nicely presented paper and nice discussion of this very devastating problem to the patient and many times to the entire staff caring for the patient.

In that late group of patients there was a 70% leak rate, four deaths, 2 patients who required subsequent esophagectomy, and an average length of stay in excess of 40 days; given all of those factors, is there another alternative approach to this one that you would consider or that you would suggest at this time should be looked into, or are you content with those figures?

DR RICHARD I. WHYTE (Ann Arbor, MI): Doctor Wright, I enjoyed your presentation a lot. It was very well done.

As you know, we also espouse primary repair whenever possible, but we do not buttress the repair. I was wondering what the evidence is that buttressing is necessary or even helpful. Second, you make the assumption that the functional result after primary repair is clearly worse than esophagectomy. I do not know if there is a lot of data to support that contention. Most of the published reports on esophageal repair or perforation deal with the acute episode in the early recovery, and there are really very few data dealing with the long-term results of this condition.

DR JAMES W. . . . [Full Text of this Article]

Related Article

Reinforced Primary Repair of Thoracic Esophageal Perforation

Cameron D. Wright, Douglas J. Mathisen, John C. Wain, Ashby C. Moncure, Alan D. Hilgenberg, and Hermes C. Grillo
Ann. Thorac. Surg. 1995 60: 245-248. [Abstract] [Full Text]

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