Copyright
©The Author(s) 2023.
World J Meta-Anal. Apr 18, 2023; 11(4): 112-124
Published online Apr 18, 2023. doi: 10.13105/wjma.v11.i4.112
Published online Apr 18, 2023. doi: 10.13105/wjma.v11.i4.112
Table 1 Descriptive comparative characteristics of all included 49 studies
Ref. | Age | Sex | Accurate diagnosis | Rupture type | Shock vital | Laceration size (cm) | Treatment | Prognosis |
Jahangir et al[4], 2021 | 64 | M | Yes | Intrapleural type | Yes | 1 | Stent, thoracic drainage | Death |
Issa et al[23], 2019 | 32 | M | Yes | Intrapleural type | No | 2 | Stent, thoracic drainage | Alive |
Tan et al[5], 2022 | 84 | M | No | Intrapleural type | No | Unknown | Thoracotomy, primary repair only | Death |
Chang et al[13], 2021 | 67 | M | Yes | Intrapleural type | No | 3 | Thoracopy, primary repair only, feeding jejunostomy | Alive |
Chang et al[13], 2021 | 62 | M | Yes | Intrapleural type | No | 2 | Thoracopy, primary repair only, feeding jejunostomy | Alive |
Sheshala et al[24], 2021 | 39 | M | No | Intrapleural type | Yes | Unknown | Stent, thoracic drainage | Alive |
Matsumoto et al[25], 2019 | 60 | M | No | Intrapleural type | Yes | Unknown | Stent, thoracic drainage | Alive |
Ayazi et al[6], 2021 | 22 | M | Yes | Intrapleural type | Yes | Unknown | Thoracotomy, esophagectomy, gastrostomy | Death |
Maki et al[44], 2022 | 76 | M | Yes | Intramediastinal type | No | 7 | Transhiatal approach, primary repair plus omentoplasty, feeding jejunostomy | Alive |
Ioannidis et al[39], 2021 | 83 | F | Yes | Intrapleural type | No | Unknown | Thoracic drainage | Alive |
Y K et al[26], 2018 | 86 | M | Yes | Intrapleural type | Yes | 5 | Stent, thoracic drainage, feeding jejunostomy | Alive |
Czopnik et al[3], 2017 | 47 | M | Yes | Intrapleural type | No | 5 | Transhiatal approach, primary repair, gastrostomy | Alive |
Awadelkarim et al[27], 2021 | 36 | M | Yes | Intrapleural type | Yes | 2 | Stent, thoracic drainage | Alive |
Chalikonda et al[28], 2019 | 74 | M | No | Intrapleural type | Yes | Unknown | Stent, thoracic drainage | Alive |
Śnieżyński et al[29], 2021 | 53 | M | Yes | Intrapleural type | No | 3 | Stent, thoracic drainage | Alive |
Matsuura et al[21], 2022 | 69 | M | Yes | Intramediastinal type | No | Unknown | Endoscopic clipping | Alive |
Chen et al[19], 2021 | 57 | M | No | Intramediastinal type | No | Unknown | Transhiatal approach, primary repair only, feeding jejunostomy | Alive |
Truyens et al[30], 2020 | 66 | M | Yes | Intramediastinal type | Yes | Unknown | Antibiotic administration | Alive |
Truyens et al[30], 2020 | 77 | M | Yes | Intramediastinal type | No | Unknown | Stent | Alive |
Swol et al[7], 2019 | 70 | M | Yes | Intramediastinal type | No | 2 | Transhiatal approach, primary repair plus fundus pauch | Death |
Park et al[45], 2021 | Unknown | Unknown | Yes | Intramediastinal type | No | 5 | Laparoscopic transhiatal approch, primary repair plus omentoplasty → endoscopic clipping, stent | Alive |
Rahman et al[49], 2021 | 53 | M | Yes | Intrapleural type | No | Unknown | Thoracotomy, primary repair plus intercostal muscle pauch, gastro-jujuno tube → stent | Alive |
Nachiappan et al[46], 2022 | 59 | M | No | Intrapleural type | No | 1,5 | Endscopic clipping, stent → laparoscopic transhiatal approach, primary repair plus omentoplasty | Alive |
Pasternak et al[14], 2019 | 37 | M | Yes | Intrapleural type | No | Unknown | Thoracotomy, primary repair only, gastrostomy | Alive |
Kita et al[55], 2022 | 46 | M | Yes | Intramediastinal type | No | 4 | Laparoscopic transhiatal approch, primary repair plus fundus pauch | Alive |
Kita et al[55], 2022 | 48 | M | Yes | Intramediastinal type | No | 3 | Laparoscopic transhiatal approch, primary repair plus fundus pauch | Alive |
Kita et al[55], 2022 | 65 | M | Yes | Intramediastinal type | No | 5 | Laparoscopic transhiatal approch, primary repair plus fundus pauch | Alive |
Saffo et al[8], 2021 | 76 | M | No | Intrapleural type | Yes | Unknown | Stent, thoracic drainage | Death |
Kochar et al[50], 2019 | 40 | M | Yes | Intrapleural type | Yes | Unknown | Thoracotomy, primary repair plus intercostal muscle pauch, intraoperative stent, thoracic drainage | Alive |
Bury et al[51], 2022 | 50 | M | No | Intrapleural type | No | 4 | Thoracotomy, primary repair plus intercostal muscle pauch, thoracic drainage | Alive |
Aref et al[47], 2019 | 32 | M | Yes | Intramediastinal type | No | 2 | Laparoscopic transhiatal approach, primary repair plus omentoplasty | Alive |
Bani Fawwaz et al[15], 2022 | 63 | M | Yes | Intrapleural type | Yes | 3 | Stent, thoracic drainage | Alive |
Bani Fawwaz et al[15], 2022 | 56 | F | Yes | Intrapleural type | No | Unknown | Thoracotomy, primary repair plus T tube, Belsey fundoplication, intraoperative stent, thoracic drainage, gastrostpomy | Alive |
Xu et al[22], 2021 | 63 | M | Yes | Intrapleural type | No | Unknown | Endoscopic clipping | Alive |
Tuñon et al[57], 2021 | 24 | M | Yes | Intrapleural type | No | 4 | Endoluminal vacuum therapy → endoscopic clipping | Alive |
Lee et al[58], 2018 | 52 | M | Yes | Intrapleural type | No | Unknown | Thoracoscopic approach, primary repair only → endoluminal vacuum therapy, thoracic drainage | Alive |
He et al[54], 2018 | 57 | M | Yes | Intramediastinal type | No | 6 | Endoscopic clipping | Death |
Kim et al[59], 2019 | 56 | M | Yes | Intrapleural type | No | Unknown | Thoracotomy, primary repair only → endoluminal vacuum therapy, thoracic drainage | Alive |
Shennib et al[52], 2021 | 47 | M | No | Intrapleural type | Yes | 5 | Thoracotomy, primary repair plus pericardial pauch, gastrostomy, feeding jejunostomy | Alive |
Agrawal et al[40], 2019 | 26 | M | No | Intrapleural type | No | Unknown | thoracic drainage | Alive |
Sato et al[31], 2018 | 52 | M | Yes | Intrapleural type | No | Unknown | Thoracotomy, primary repair only → stent, thoracic drainage | Alive |
Sato et al[31], 2018 | 53 | M | No | Intrapleural type | Yes | Unknown | Stent, thoracic drainage | Alive |
Ali et al[16], 2020 | 30 | F | No | Intrapleural type | No | 4 | Thoracotomy, primary repair only | Alive |
Anand et al[48], 2022 | 64 | M | Yes | Intrapleural type | No | 2 | Thoracotomy, primary repair plus intercostal muscle pauch, thoracic drainage | Alive |
Barakat et al[32], 2017 | 62 | M | Yes | Intrapleural type | No | 1 | Stent, endoscopic clipping | Alive |
Alakkari et al[17], 2019 | 69 | F | Yes | Intrapleural type | No | Unknown | Thoracotomy, primary repair plus T tube | Alive |
Zhu et al[18], 2021 | 33 | M | No | Intrapleural type | No | Unknown | Stent, PEG →thoracotomy, drainage | Alive |
Sekiya et al[56], 2019 | 61 | M | Yes | Intrapleural type | No | 3 | Thoracoscopic and laparoscopic approach, primary repair plus pericardial pauch, gastrostomy | Alive |
Sekiya et al[56], 2019 | 64 | M | Yes | Intrapleural type | No | 4 | Thoracoscopic and laparoscopic approach, primary repair plus pericardial pauch, feeding jejunostomy | Alive |
Olivero et al[53], 2019 | 67 | M | No | Intrapleural type | No | 2 | Thoracotomy, primary repair plus pericardial pauch, thoracic drainage | Alive |
Felipe et al[38], 2021 | 47 | M | Yes | Intrapleural type | No | 12 | Thoracotomy and laparotomy approach, esophagostomy, gastrostomy → stent | Alive |
Ahmad et al[33], 2018 | 63 | M | Yes | Intrapleural type | No | 2.5 | Stent, thoracic drainage | Alive |
Hashmi et al[10], 2021 | 83 | M | Yes | Intrapleural type | Yes | Unknown | Antibiotic administration | Death |
Teblick et al[34], 2018 | 74 | M | Yes | Intrapleural type | No | Unknown | Stent, thoracic drainage | Alive |
He et al[9], 2018 | 27 | M | Yes | Intrapleural type | No | 6 | Thoracotomy, primary repair plus pleural flap, feeding jejunostomy | Alive |
Table 2 Characteristics of the patients with Boerhaave syndrome included in the review, n (%)
Sex | aMale 51, female 4 | |
Age | 55.8 ± 16 | |
The length from symptom within 24 h | b36 (65.5) | |
The method of diagnosis | CT | 31 |
Esophagography | 15 | |
Endoscopy | 9 | |
Exploratory laparotomy | 1 | |
Accurate diagnosis on admission | 42 (75) | |
Shock vital on admission | 14 (25) | |
Rupture type | Intramediastinal | 12 (21.4) |
Extramediatinal | 44 (78.6) | |
Lacelation size (cm) (range) | c3.8 (1-12) |
Table 3 Initial treatment for Boerhaave syndrome
The number do not add up because of duplication case | |||
Conservation (n = 25)a | Esophageal stent | 17 | |
Clipping | 5 | ||
Thoracic drainage | 21 | ||
EVACb | 1 | ||
Operation (n = 31) | Approach | Trans-thoracic approach | 18 |
Trans-abdominal approach | 10 | ||
Trans-thoracic and abdominal approach | 3 | ||
Method | Primary repair only | 8 | |
Primary repair with omentoplasty | 6 | ||
Primary repair with fundus pauch | 6 | ||
Primary repair with intercostal muscle pauch | 5 | ||
Primary repair with pericardial fat pauch | 5 | ||
T tube | 2 | ||
Esophagectomy | 1 | ||
Esophagostomy and gastrostomy | 1 |
Table 4 The length of hospital stay was not significantly different among the 43 cases
Factor | Group | Operation (n = 31) | Conservation (n = 25) | Pvalue |
Sex (%) | M | 27 (90.0) | 24 (96.0) | 0.617 |
F | 3 (10.0) | 1 ( 4.0) | ||
mean ± SD | 53.17 (14.68) | 59.00 (18.14) | 0.193 | |
The length from symptom within 24 h (%) | Yes | 10 (32.3) | 9 (36.0) | 1 |
No | 20 (64.5) | 16 (64.0) | ||
Shock vital on admission (%) | Yes | 3 ( 9.7) | 11 (44.0) | 0.005 |
No | 28 (90.3) | 14 (56.0) | ||
rupture type | Intramediastinal (%) | 8 (25.8) | 4 (16.0) | 0.516 |
Extramediastinal (%) | 23 (74.2) | 21 (84.0) | ||
Alive (%) | Yes | 28 (90.3) | 21 (84.0) | 0.688 |
No | 3 ( 9.7) | 4 (16.0) |
- Citation: Yamana I, Fujikawa T, Kawamura Y, Hasegawa S. Current approach for Boerhaaves syndrome: A systematic review of case reports. World J Meta-Anal 2023; 11(4): 112-124
- URL: https://www.wjgnet.com/2308-3840/full/v11/i4/112.htm
- DOI: https://dx.doi.org/10.13105/wjma.v11.i4.112