TY - JOUR
T1 - Treatment strategies for Boerhaave syndrome
T2 - multinational retrospective cohort study
AU - Hauge, Tobias
AU - Abu Hejleh, Aram
AU - Aiolfi, Alberto
AU - Berlth, Felix
AU - Bonavina, Luigi
AU - Brake, Linda
AU - Conradi, Lena Christin
AU - D’Journo, Xavier Benoit
AU - Edholm, David
AU - Elliot, Jessie
AU - Eshuis, Wietse
AU - Friedrich, Nora
AU - Gisbertz, Suzanne
AU - Grimminger, Peter
AU - Gutschow, Christian Alexander
AU - Joglekar, Shantanu
AU - Klarenbeek, Bastiaan
AU - Klevebro, Fredrik
AU - Kooij, Cezanne D.
AU - Luyer, Misha
AU - Milazzo, Alfio
AU - Moletta, Lucia
AU - Moons, Johnny
AU - Moorthy, Krishna
AU - Müller-Stich, Beat P.
AU - Nienhüser, Henrik
AU - Nafteux, Philippe
AU - Nezi, Giulia
AU - Nico, Raphael
AU - Neuschütz, Kerstin J.
AU - Nieuwenhuijzen, Grard
AU - Raftery, Nicola
AU - Renger, Franziska
AU - Rouvelas, Ioannis
AU - Ruurda, Jelle P.
AU - Schneider, Marcel A.
AU - Polette Stubb, Daniela
AU - Todesco, Alban
AU - Valmasoni, Michele
AU - Van Berge Henegouwen, Mark I.
AU - Van Daele, Elke
AU - Van Hillegersberg, Richard
AU - Van Hootegem, Sander J.M.
AU - Vanommeslaeghe, Hanne
AU - Veziant, Julie
AU - Wijnhoven, Bas
AU - Vilela, João Pedro
AU - Bruns, Christiane J.
AU - Nilsson, Magnus
AU - Schröder, Wolfgang
N1 - Publisher Copyright:
© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved.
PY - 2025/12
Y1 - 2025/12
N2 - Background: Boerhaave syndrome is defined as a spontaneous perforation of the oesophagus. The mainstay of treatment is resuscitation of the patient, closure of the oesophageal defect, and drainage of perioesophageal and pleural fluid collections. Whether the optimal approach is endoscopic, surgical, or conservative management remains unknown and there are no clear guidelines. The aim of this multicentre retrospective cohort study was to evaluate current treatment strategies and outcomes for Boerhaave syndrome. Methods: A multicentre retrospective analysis of data from 23 participating European tertiary centres was performed. Patients with Boerhaave syndrome treated between January 2019 and December 2023 were eligible for inclusion. The primary endpoint was the length of ICU stay and secondary endpoints included in-hospital mortality, 90-day mortality, and the length of overall hospital stay. Results: In total, 216 patients were included; 151 were men (70%), the median age was 62 (22–95) years, and 81 (40%) were treated >24 h after the start of symptoms. Seventy (32%) patients were managed endoscopically (group I), 73 (34%) were managed surgically (group II), 67 (31%) were managed using a combination of endoscopy and surgery (group III), and 6 (3%) were managed using other methods (group IV). For patients in groups I–III: the median length of ICU stay was 8 (0–67) days, with no differences between the three groups (P = 0.105); the in-hospital mortality rate and 90-day mortality rate were both 12% (P = 0.490 and P = 0.637, respectively); and the median length of overall hospital stay was 27 (range 1–193) days, with the longest stays observed in patients who received combined treatment (P = 0.032). Conclusion: This study provides a comprehensive overview of the current treatment strategies and outcomes for patients with Boerhaave syndrome in Europe.
AB - Background: Boerhaave syndrome is defined as a spontaneous perforation of the oesophagus. The mainstay of treatment is resuscitation of the patient, closure of the oesophageal defect, and drainage of perioesophageal and pleural fluid collections. Whether the optimal approach is endoscopic, surgical, or conservative management remains unknown and there are no clear guidelines. The aim of this multicentre retrospective cohort study was to evaluate current treatment strategies and outcomes for Boerhaave syndrome. Methods: A multicentre retrospective analysis of data from 23 participating European tertiary centres was performed. Patients with Boerhaave syndrome treated between January 2019 and December 2023 were eligible for inclusion. The primary endpoint was the length of ICU stay and secondary endpoints included in-hospital mortality, 90-day mortality, and the length of overall hospital stay. Results: In total, 216 patients were included; 151 were men (70%), the median age was 62 (22–95) years, and 81 (40%) were treated >24 h after the start of symptoms. Seventy (32%) patients were managed endoscopically (group I), 73 (34%) were managed surgically (group II), 67 (31%) were managed using a combination of endoscopy and surgery (group III), and 6 (3%) were managed using other methods (group IV). For patients in groups I–III: the median length of ICU stay was 8 (0–67) days, with no differences between the three groups (P = 0.105); the in-hospital mortality rate and 90-day mortality rate were both 12% (P = 0.490 and P = 0.637, respectively); and the median length of overall hospital stay was 27 (range 1–193) days, with the longest stays observed in patients who received combined treatment (P = 0.032). Conclusion: This study provides a comprehensive overview of the current treatment strategies and outcomes for patients with Boerhaave syndrome in Europe.
UR - https://www.scopus.com/pages/publications/105023453285
U2 - 10.1093/bjs/znaf260
DO - 10.1093/bjs/znaf260
M3 - Article
C2 - 41324551
AN - SCOPUS:105023453285
SN - 0007-1323
VL - 112
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 12
M1 - znaf260
ER -