caa a22 4500 475778901 CHVBK 20180406123638.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1007/s004640000164 doi (NATIONALLICENCE)springer-10.1007/s004640000164 Incidence and significance of pneumomediastinum after laparoscopic esophageal surgery [Elektronische Daten] [R. H. Clements, S. Reddy, M. D. Holzman, K. W. Sharp, D. Olsen, G. W. Holcomb, W. O. Richards] Background: Pneumomediastinum can be a sign of esophageal perforation. During laparoscopic esophageal surgery, the mediastinum is exposed to carbon dioxide gas under pressure that can cause pneumomediastinum. Methods: Forty-five patients undergoing laparoscopic esophageal procedures had erect, inspiratory, single-view chest radiographs (CXR) performed in the recovery room (RR). Patients with extraabdominal gas underwent daily erect, inspiratory, single-view CXR until resorption of the gas or discharge from the hospital. Insufflation time and pressure were recorded, and morbidity was evaluated. Results are expressed as mean ± SEM. Results: Twenty-five mens (56%)and 20 women (44%) aged 33.0 ± 2.9 years underwent 10 Heller myotomies (22.2%), 27 Nissen fundoplications (60.0%), six Toupet fundoplications (13.3%), and two paraesophageal hernia repairs (4.4%). Twenty-four patients (53.3%) had normal CXR in RR, and 21 (46.7%) had extraabdominal gas. Eighteen (85.7%) of the 21 had pneumomediastinum, three (14.3%) had pneumothorax, and 12 (57.1%) had subcutaneous emphysema in RR. Sixteen of these 21 remained hospitalized and had repeat CXR on postoperative day 1. Of these 16, five (31.3%) had normal CXR, 11 (68.8%) had pneumomediastinum, and seven (43.8%) had subcutaneous emphysema. There were no esophageal perforations and no chest tube insertions, and there was no morbidity related to pneumomediastinum. Conclusion: Pneumomediastinum is observed frequently following laparoscopic esophageal operations and often persists past 24 h. After these operations, pneumomediastinum is not necessarily indicative of esophageal perforation. In this group, it caused no clinically significant events that altered the course of the patients. Springer-Verlag New York Inc., 2000 Key words: Esophagus — Laparoscopy — Pneumomediastinum nationallicence Clements R. H. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut Reddy S. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut Holzman M. D. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut Sharp K. W. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut Olsen D. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut Holcomb G. W. Department of Pediatric Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut Richards W. O. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut Surgical Endoscopy Springer-Verlag 14/6(2000-06-01), 553-555 0930-2794 14:6<553 2000 14 464 https://doi.org/10.1007/s004640000164 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000164 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Clements R. H. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut NATIONALLICENCE 700 1- Reddy S. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut NATIONALLICENCE 700 1- Holzman M. D. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut NATIONALLICENCE 700 1- Sharp K. W. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut NATIONALLICENCE 700 1- Olsen D. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut NATIONALLICENCE 700 1- Holcomb G. W. Department of Pediatric Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut NATIONALLICENCE 700 1- Richards W. O. Department of Surgery, Vanderbilt University, Medical Center, Room D5203MCN, Nashville, TN 37232-2577, USA, US aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/6(2000-06-01), 553-555 0930-2794 14:6<553 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer