Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Apr 18, 2023; 11(4): 112-124
Published online Apr 18, 2023. doi: 10.13105/wjma.v11.i4.112
Current approach for Boerhaaves syndrome: A systematic review of case reports
Ippei Yamana, Takahisa Fujikawa, Yuichiro Kawamura, Suguru Hasegawa
Ippei Yamana, Takahisa Fujikawa, Yuichiro Kawamura, Department of Surgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka 802-8555, Japan
Suguru Hasegawa, Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
Author contributions: Yamana I and Fujikawa T contributed equally to this work; Yamana I and Fujikawa T designed the research study; Yamana I and Fujikawa T performed the research; Kawamura Y contributed new reagents and analytic tools; Yamana I analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Takahisa Fujikawa, FACS, MD, PhD, Chief Doctor, Department of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, Japan. fujikawa-t@kokurakinen.or.jp
Received: December 16, 2022
Peer-review started: December 16, 2022
First decision: January 31, 2023
Revised: February 7, 2024
Accepted: April 6, 2023
Article in press: April 6, 2023
Published online: April 18, 2023
Processing time: 119 Days and 3.6 Hours
ARTICLE HIGHLIGHTS
Research perspectives

As far, it has long been reported that Boerhaave syndrome has a poor prognosis when diagnosed late. However, no consensus has been reached concerning the appropriate therapeutic strategy for Boerhaave syndrome because of the rarity of the disease and the changing therapeutic trends.

Research conclusions

We assess the therapeutic methods [operation vs drainage vs stent vs endoluminal vacuum-assisted (EVAC), etc.] and clinical outcomes and discuss the current trends in the management of Boerhaave syndrome.

Research results

We believe that this systematic review will be useful in future treatment of Boerhaave syndrome when there is doubt as to whether conservative treatment or surgery should be done, as well as the method of surgery.

Research methods

We searched PubMed, Google scholar, MEDLINE, and The Cochrane Library for studies concerning Boerhaave syndrome published between 2017 and 2022.

Research objectives

In results, the key to treatment of Boerhaave syndrome was early diagnosis. In addition, although surgery was the basic treatment, esophageal stents and drainage may be useful for patients with intolerance. Furthermore, for postoperative leakage, esophageal stents, drainage, and EVAC were useful.

Research motivation

In the treatment of Boerhaave syndrome, it is most important to diagnose the issue immediately. Primary repair with reinforcement is the gold-standard procedure. The indication of endoscopic esophageal stenting or endoluminal vacuum-assisted therapy should always be considered for patients in a poor general condition and who continue to have leakage after repair.

Research background

Because Boerhaave syndrome is a rare disease, observational studies should be conducted in collaboration with other centers. We hope that this will result in a high-quality strategy.