Minimally invasive surgeryLong-term results of minimally invasive surgery for symptomatic epiphrenic diverticulum
Section snippets
Methods
From January 1994 to May 2009, 20 patients (13 men, 7 women; median age, 62 years; range, 43–82 years) with symptomatic epiphrenic diverticulum underwent laparoscopic surgery in our department. Diverticulectomy, myotomy, and partial fundoplication were performed in 18 patients (90%). Two patients (10%) received laparoscopic myotomy and partial fundoplication only. Preoperative workup included symptom recording, radiographic and endoscopic examinations, and manometry. Symptoms at the time of
Results
Associated procedures were performed in 3 patients (15%): simultaneous cholecystectomy was performed in 2 patients with symptomatic gallstones, and adhesiolysis to clear the abdominal cavity after a previous open cholecystectomy was performed in another patient. The median length of myotomy was 9 cm (range, 5–13 cm). Partial fundoplication consisted of 90° anterior procedures (Dor) in 14 patients (70%) and 270° posterior procedures (Toupet) in 6 patients (30%). There was no conversion to open
Comments
Our experience is that resection of diverticula up to 12 cm above the LES, with myotomy (the longest myotomy was 13 cm in length in the highest diverticulum of the series) and antireflux wrap, can be performed laparoscopically by the transhiatal approach, safely and without undue difficulty, provided that the entire diverticulum can be dissected free of surrounding structures. An angled scope is needed to afford adequate exposure of the proximal margin of the diverticular neck. Even so, it may
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Giant esophageal diverticulum with stenosis treated with mediastinoscopic esophagectomy: A case report
2020, International Journal of Surgery Case ReportsCitation Excerpt :Some reports have indicated that leakage occurs in 7.7–27.2 % of patients after diverticulectomy and myotomy for esophageal diverticula [4–6]. Recently, laparoscopic diverticulectomy with myotomy and fundoplication has been considered the best approach in most cases [7–9]. Our case was a giant diverticulum with stenosis in the anal side.
Surgical Management of Mid- and Distal Esophageal Diverticula
2019, Shackelford's Surgery of the Alimentary Tract: 2 Volume SetSurgical Management of Esophageal Epiphrenic Diverticula: A Transthoracic Approach Over Four Decades
2017, Annals of Thoracic SurgeryCitation Excerpt :Regarding postoperative outcomes, four are of main interest: morbidity, leak rate, operative mortality, and relief of symptoms. Our overall morbidity rate of 35.5% is comparable to the reported postoperative morbidity of 5% to 45% in other series [3–13]. We show that death and leak are uncommon after repair.
Esophageal epiphrenic diverticulum associated with diffuse esophageal spasm
2015, International Journal of Surgery Case ReportsCitation Excerpt :Epiphrenic diverticula are most frequently associated with achalasia [1–8]. When the achalasia is the cause of the diverticulum, surgical treatment comprising diverticulectomy, myotomy, and fundoplication is required [1–7]. This treatment is generally performed by a laparoscopic approach [4,8].
Management of Epiphrenic Diverticula and Short-term Outcomes
2021, Seminars in Thoracic and Cardiovascular SurgeryCitation Excerpt :In our series, sizes of diverticula up to 9cm and length from GEJ up to 5 cm were approached successfully through a laparoscopic only approach. We find our series similar to that of Peracchia et al,9 in their study of 20 laparoscopically treated epiphrenic diverticula over a 15 year period, who had a mean diverticular size of 4.5cm (range 2–8 cm) on barium swallow and mean distance from cardia of 4.1cm (range 2–12 cm) at endoscopy. These authors reported successful completion of a myotomy in all patients that extended up to or just beyond the proximal extent of the diverticulum.
Thoracoscopy for esophageal diverticulum after congenital esophageal atresia in children
2023, Chinese Journal of Pediatric Surgery
This article reports the long term results of minimally invasive treatment in 20 patients affected by symptomatic epiphrenic diverticulum.