344. SURGICAL APPROACH FOR SPONTANEOUS ESOPHAGEAL RUPTURE: THORACOSCOPY COMBINED WITH GASTROSCOPY AND TRADITIONAL THORACOTOMY

Abstract Objective To explore the surgical treatment of spontaneous esophageal rupture, reduce the trauma and improve the cure rate. Methods A total of 21 patients with spontaneous esophageal rupture were selected from June 2010 to June 2022. In the thoracoscopy combined with gastroscopy group, 12 patients were treated with thoracoscopic debridement, esophageal rupture repair, thoracic drainage with closed drainage tube, nasal drainage with gastroscope and nasal duodenal feeding tube placement. In the thoracotomy group, 9 patients performed scheduled thoracotomy. Results Compared with the thoracotomy group, the thoracoscopy combined with gastroscopy group had less incision pain, shorter operation time, less surgical bleeding, and lower incidence of incision infection, pulmonary infection and arrhythmia, with statistical significance (P < 0.05), while the incidence of anastomotic fistula and mortality showed no statistical significance (P > 0.05). Conclusion Spontaneous esophageal rupture is an emergency in thoracic surgery, and the combined operation of thoracoscopy and gastroscopy after early diagnosis has less trauma, faster recovery and good therapeutic effect.