There is no consensus on the appropriate therapeutic strategy for Boerhaave syndrome due to its rarity and changing therapeutic approaches. We conducted a systematic review of case reports documenting Boerhaave syndrome.

To assess the therapeutic methods and clinical outcomes and discuss the current trends in the management of Boerhaave syndrome.

We searched PubMed, Google scholar, MEDLINE, and The Cochrane Library for studies concerning Boerhaave syndrome published between 2017 and 2022.

Of the included studies, 49 were case reports, including a total of 56 cases. The mean age was 55.8 ± 16 years old. Initial conservative treatment was performed in 25 cases, while operation was performed in 31 cases. The rate of conservative treatment was significantly higher than that of operation in cases of shock vital on admission (9.7% vs 44.0%; P = 0.005). Seventeen out of 25 conservative cases (68.0%) were initially treated endoscopic esophageal stenting; 2 of those 17 cases subsequently underwent operation due to poor infection control. Twelve cases developed postoperative leakage (38.7%), and 4 of those 12 cases underwent endoscopic esophageal stenting to stop the leakage. The length of the hospital stay was not significantly different between the conservative treatment and operation cases (operation vs conservation: 33.52 ± 22.69 vs 38.81 ± 35.28 days; P = 0.553).

In the treatment of Boerhaave syndrome, it is most important to diagnose the issue immediately. Primary repair with reinforcement is the gold-standard procedure. The indication of endoscopic esophageal stenting or endoluminal vacuum-assisted therapy should always be considered for patients in a poor general condition and who continue to have leakage after repair.

• Boerhaave syndrome
• Esophageal perforation
• Self expandable metalic stent
• Minimally invasive surgical procedures
• Anastomotic leakage
• Shock

Endoscopic negative-pressure therapy (ENPT) is becoming a valuable tool in surgical complication management of transmural intestinal defects and wounds in the upper and lower gastrointestinal tract. Innovative materials for drains have been developed, endoscopic techniques adapted, and new indications for ENPT have been found. Based on our broad clinical experience, numerous tips and tricks are described, which contribute to the safety of dealing with the new therapy. The aim of this work is to present these methods. The focus is on describing the treatment in the esophagus.

• Drainage
• Endoscopic vacuum therapy
• Esophagus
• Leakage
• Overtube

• Drainage
• Endoscopy/methods
• Esophagus
• Gastrointestinal Tract/surgery
• Negative-Pressure Wound Therapy

• Defect
• Endoscopic vacuum therapy
• Endoscopy
• Fistula
• Gastrointestinal
• Leak
• Negative pressure therapy
• Perforation

• Anastomotic leakage
• Drainage
• Endoscopic vacuum therapy
• Esophagus
• Perforation

• Anastomotic Leak
• Endoscopy
• Humans
• Negative-Pressure Wound Therapy
• Upper Gastrointestinal Tract/surgery

• Anastomotic leakage
• Drainage
• Endoscopic vacuum therapy
• Esophagus
• Perforation