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Modern pathophysiology and treatment of esophageal diverticula

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Abstract

Introduction

Esophageal diverticula are rare. They may occur in the pharyngoesophageal area (Zenker's), midesophagus, or distally (epiphrenic). A motility disorder (either at the level of the esophageal sphincters or body) is frequently associated with esophageal diverticula. The risk of malignant transformation is low.

Methods

A literature search was performed using Medline/PubMed database.

Results

The treatment of esophageal diverticula must be based on the pathophysiology and natural history of the disease: (a) asymptomatic diverticula do not need a specific treatment, (b) small diverticula may be left in place and not resected, (c) medium-size diverticula may be either treated by diverticulectomy, diverticulopexy, or esophagodiverticulostomy in case of pharyngoesophageal diverticula, (d) resection is probably the ideal therapy for larger diverticula, and (e) a myotomy should always be included to the procedure.

Conclusions

Due to its rarity, esophageal diverticula must be treated by esophageal surgeons since even in experienced hands the complication rate can be significant.

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Authors and Affiliations

  1. Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil

    Fernando A. M. Herbella

  2. Department of Surgery, University of Chicago, Chicago, USA

    Marco G. Patti

  3. Surgical Gastroenterology, Division of Esophagus and Stomach, Hospital Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo, SP, Brazil, 04037-003

    Fernando A. M. Herbella

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  1. Fernando A. M. Herbella
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  2. Marco G. Patti
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Correspondence to Fernando A. M. Herbella.

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Herbella, F.A.M., Patti, M.G. Modern pathophysiology and treatment of esophageal diverticula. Langenbecks Arch Surg 397, 29–35 (2012). https://doi.org/10.1007/s00423-011-0843-2

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  • DOI: https://doi.org/10.1007/s00423-011-0843-2

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