To improve the treatment of patients with perforation of the esophagus with complicated acute purulent mediastinitis.
Materials and Methods: During 2004-2018 at the Department of Thoracic Surgery, Ivano-Frankivsk Regional Clinical Hospital, we examined and treated 30 patients with perforation of the esophagus with complicated acute purulent mediastinitis. The age of patients is from 21 to 76 years, on average 36,3 ± 3,9 years. Men were21(70%), women 9 (30%).
Results:At the application of intramedistinal administration of antibacterial drugs and the method of irrigation of the seams of the esophagus, a faster elimination of purulent-inflammatory process in the mediastine was observed. Complete sealing of the joints of the perforated part of the esophagus in 6 (37.5%) patients, reduction of the size of the defect of the esophagus wall - in 9 (56.2%) patients.
Conclusions: 1. Sewing of the perforation of the esophagus should be performed to distinguish the esophagus from the mediastinum, localization of the purulent process in the mediastinum and to stabilize the general condition of the patient.
2. Mini invasive surgical treatment using video-assisted thoracoscopy can serve as a selection option for patients with perforation of the esophagus in the common forms of acute purulent mediastinitis for the rehabilitation and drainage of the purulent-inflammatory process in the mediastinum, stabilization of the patient's condition and prevention of septic complications.
3. The use of intramediastinal administration of antibacterial drugs and the method of irrigation of the seams of the esophagus can improve the results of treatment, reduce endogenous intoxication, improve the healing of perforation of the esophagus, and eliminate the purulent process in the mediastinum.