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lüll Surgical management of Boerhaave s syndrome in a tertiary oesophagogastric centre Sutcliffe RP; Forshaw MJ; Datta G; Rohatgi A; Strauss DC; Mason RC; Botha AJAnn R Coll Surg Engl 2009[Jul]; 91 (5): 374-80INTRODUCTION: The aim of this study was to review the management and outcome of patients with Boerhaave's syndrome in a specialist centre between 2000-2007. PATIENTS AND METHODS: Patients were grouped according to time from symptoms to referral (early, < 24 h; late, > 24 h). The effects of referral time and management on outcomes (oesophageal leak, reoperation and mortality) were evaluated. RESULTS: Of 21 patients (early 10; late 11), three were unfit for surgery. Of the remaining 18, immediate surgery was performed in 8/8 referred early and 6/10 referred late. Four patients referred late were treated conservatively. Oesophageal leak (78% versus 12.5%; P < 0.05) and mortality (40% versus 0%; P < 0.05) rates were higher in patients referred late. For patients referred late, mortality was higher in patients managed conservatively (75% versus 17%; not significant). CONCLUSIONS: The best outcomes in Boerhaave's syndrome are associated with early referral and surgical management in a specialist centre. Surgery appears to be superior to conservative treatment for patients referred late.|Aged[MESH]|Drainage[MESH]|Esophageal Perforation/complications/diagnostic imaging/*surgery[MESH]|Esophagoplasty/methods[MESH]|Female[MESH]|Hospital Mortality[MESH]|Humans[MESH]|Length of Stay/statistics & numerical data[MESH]|Male[MESH]|Mediastinitis/*etiology/surgery[MESH]|Middle Aged[MESH]|Postoperative Care/methods[MESH]|Radiography[MESH]|Referral and Consultation/statistics & numerical data[MESH]|Reoperation[MESH]|Retrospective Studies[MESH]|Rupture, Spontaneous/complications/diagnostic imaging/*surgery[MESH]|Sepsis/*etiology[MESH]|Syndrome[MESH]|Time Factors[MESH]|Treatment Outcome[MESH] |