Published online Apr 18, 2023. doi: 10.13105/wjma.v11.i4.112
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
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.
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.
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.
We searched PubMed, Google scholar, MEDLINE, and The Cochrane Library for studies concerning Boerhaave syndrome published between 2017 and 2022.
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.
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.
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.