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ANZMOSS - ANZGOSA 2020 Virtual Conference
ANZMOSS – ANZGOSA 2020 Virtual Conference
ANZMOSS - ANZGOSA 2020 Virtual Conference
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The Management of Boerhaave Syndrome in Australasia: A Retrospective Case Series and Systematic Review of the Australasian Literature

Description
BACKGROUND
Boerhaave syndrome is a rare and life-threatening condition characterised by a spontaneous transmural tear of the oesophagus. There remains wide variation in the condition’s management with non-operative management (NOM) and surgery being the two main treatment strategies. The aim was to review the presentation, management and outcomes for patients treated for Boerhaave syndrome at our institution and to compare this data with that previously reported within the Australasian literature. 
 
METHODS
A retrospective case series was performed for consecutive patients diagnosed with Boerhaave syndrome at our institution between January 2000 and January 2020. A systematic review of the Australasian literature was also performed. 
 
RESULTS
Case series - 15 patients were included (n=2 NOM, n=13 operative). The most common operative technique was primary repair with intercostal drainage via thoracotomy. Major complications occurred in 11 (73%) patients. Median Comprehensive Complication Index (CCI) was 53.4 (IQR: 50). There was one death, in the operative management group. Median length of hospital stay was 33 days (IQR: 58). There was no statistically significant difference in CCI between those in the NOM and operative groups (p=0.80).
 
Systematic review - 11 articles were included; four case series and seven case reports. From these 23 patients met inclusion criteria. The majority of patients (83%) were managed operatively, with only four undergoing NOM. Seven patients died, representing an overall mortality rate of 30
 
CONCLUSIONS
We provide an updated overview of the management of Boerhaave syndrome within Australasia. Aggressive operative management is associated with reasonable outcomes. 
Authors
Professor Michael Hollands - , Dr Emma Johnston - , Professor Arthur Richardson - , jane sinclair - , Paul Morris - , and Dr Matthew Allaway -