Table 2. Individual patient profile and treatment details.
Year | Case No. | Age/ Sex | Type of intervention before referral | Time of presentation (Early vs. Delayed) | Location of perforation3 | Perforation size | Contained perforation (Yes/No) | Site of pleural collection | PPSS | Details of primary intervention(s) | Re-intervention |
2005 | 1 | 67/M | Non-referral | Early | Lower thoracic, 2 cm above GEJ |
3 cm | Yes | None1’ | 4 | Laparotomy, trans-hiatal primary repair, omentoplasty and FJ | Tube thoracostomy for left-sided pleural effusion1’ |
2008 | 2 | 80/F | Right-sided, tube thoracostomy | Delayed | Lower thoracic | N/l | No | Right | 10 | Right thoracotomy, drainage, decortication and FJ | None |
3 | 62/M | Left-sided, tube thoracostomy | Delayed | Lower thoracic | N/A | Yes | Left | 3 | Left-sided, tube thoracostomy, gastrostomy and FJ | None | |
2010 | 4 | 28/M | Non-referral | Delayed | Lower thoracic | N/A | Yes | Left | 9 | Left-sided, tube thoracostomy, FJ | None |
2011 | 5 | 47/M | Right thoracotomy, pleural drainage alone | Delayed | Lower thoracic | N/M | No | Right | 9 | Right thoracotomy, drainage, decortication, esophageal stenting (FCSEMS) and FJ | Stent migration ~^· endoscopic repositioning |
6 | 41/M | Left-sided, tube thoracostomy | Delayed | Lower thoracic, 2 cm above GEJ |
3 cm | No | Left | 10 | Laparotomy, trans-hiatal repair over aT-tube, left thoracotomy, drainage, decortication, gastrostomy and FJ | None | |
2012 | 7 | 61/M | Non-referral | Delayed | Lower thoracic, 37-39 cm |
2 cm | No | Left | 6 | Left-sided, tube thoracostomy, esophageal stenting (FCSEMS), FJ | None |
2013 | 8 | 50/M | Non-referral | Delayed | Lower thoracic | 3 cm | No | Left | 11 | Laparotomy, trans-hiatal repair over aT-tube, left thoracotomy, drainage, decortication, gastrostomy and FJ | None |
9 | 47/M | Non-referral | Delayed | Lower thoracic, 2 cm above the GEJ |
3 cm | No | Bilateral | 12 | Laparotomy, trans-hiatal primary repair, omentoplasty, bilateral thoracoscopic drainage, gastrostomy and FJ | None | |
2014 | 10 | 55/M | Right thoracotomy, pleural drainage | Delayed | Lower thoracic, 34-36 cm |
2 cm | No | Left | 6 | Left-side, tube thoracostomy, esophageal stenting (ECSEMS) and EJ | Left-sided residual pleural collection ~^· image-guided drainage |
2016 | 11 | 70/M | Non-referral | Delayed | Lower thoracic, just above the GEJ | 1 cm | No | Left | 12 | On-table endoscopy, left-thoracoscopic drainage, decortication and EJC | Post-op contrast study showed a leak —> stented (ECSEMS) stent migration -^· endoscopic repositioning |
2018 | 12 | 37/F | Non-referral | Early | Lower thoracic, 31-33 cm |
2 cm | No | Right | 8 | On-table endoscopy, clipping of the perforation, right-thoracoscopic drainage and EJ | Persistent leak -^· stented (FCSEMS) stent migration -»endoscopic repositioning |
PPSS: Pittsburgh perforation severity score, M: Male, F: Female, GEJ: Gastro-esophageal junction, FJ: Feeding jejunostomy, FCSEMS: Fully covered self-expanding metal stent, N/l: Not identified (The perforation is not identified intra-op), N/A: Not applicable (No endoscopy or esophageal surgery attempted; hence size of the perforation cannot be commented on), N/M: Not mentioned (Although perforation identified either in endoscopy or intra-op, its size was not mentioned). a:The location of the perforation was identified using either radiological or endoscopic or intra-op assessment or their combination b: Pleural effusion developed following the primary intervention, but there was no evidence of a postoperative esophageal leak in the re-imaging c: On-table endoscopy showed an erosion in the lower thoracic esophagus, but the CT showed no obvious contrast leak and the perforation was not identified intra-op; hence stenting was not considered during the index operation. |