Minimally Invasive Surgery Combined With Peroperative Endoscopy for Symptomatic Middle and Lower Esophageal Diverticula

Palanivelu, Chinnusamy; Rangarajan, Muthukumaran; Maheshkumaar, Gobi Shanmugam; Senthilkumar, Rangasamy

doi:10.1097/sle.0b013e31815acb97

Cited by 29 publications

(15 citation statements)

References 14 publications

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“…The complication rate is still high for the procedure. Leaks range from 8% to 23% [4,6,7,[52][53][54][55], pulmonary complications from 8% to 10% [4,7], and the mortality rate from 0% to 7% [23]. Thoracoscopy seems to bring comparable results [40].…”

Section: Epiphrenic Diverticulummentioning

confidence: 89%

Modern pathophysiology and treatment of esophageal diverticula

Herbella

Patti

2011

Langenbecks Arch Surg

106

114

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Section: Epiphrenic Diverticulummentioning

confidence: 89%

Modern pathophysiology and treatment of esophageal diverticula

Herbella

Patti

2011

Langenbecks Arch Surg

106

114

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“…There were no major complications in the study published by Palanivelu et al [27] whereas other studies stated rates of reoperation for complications in as much as 17% [28] and 20% [29]. The largest study of minimally invasive operations published to date encompassed 20 patients among which there were 4 midthoracic diverticula.…”

Section: Discussionmentioning

confidence: 99%

“…A different study of six patients described an overall complication rate of 50% with one intraoperative perforation [28]. Rates for postoperative leakages vary between 0% [27] and 33% [30]. Within a total of 10 different retrospective studies covering 92 patients there occurred 12 leakages (13.0%) [25].…”

Section: Discussionmentioning

confidence: 99%

MIS approach for diverticula of the esophagus

Laubert¹,

Hildebrand²,

Roblick³

et al. 2010

Eur J Med Res

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PurposeDiverticula of the esophagus represent a rare pathological entity. Distinct classifications of the disease imply different surgical concepts. Surgery should be reserved for symptomatic patients only. Minimally invasive surgery (MIS) for treatment of esophageal diverticula encompasses rigid and flexible intraluminal endoscopy, thoracoscopy and laparoscopy. We here give an overview on the pathogenesis of esophageal diverticula, the minimally invasive surgical techniques for treatment and the recent literature. Additionally, we present our own experience with MIS for midthoracic diverticula.MethodsWe analyzed the cases of patients who underwent MIS for midthoracic diverticula with regard to preoperative symptoms, perioperative and follow-up data.ResultsThree patients (two female, one male, age 79, 78 and 59 years) received thoracoscopic surgery for midthoracic diverticula. All patients reported of dysphagia and regurgitation. In two patients pH-investigation showed pathological reflux but manometry was normal in all patients. Operating time was 205, 135 and 141 minutes. We performed intraoperative intraluminal endoscopy in all patients. There were no intraoperative complications and although no surgical complications occured postoperatively one patient developed pneumonia which advanced to sepsis and lethal multi organ failure. Upon follow-up the two patients did not have recurrent diverticula or a recurrence of previous symptoms.ConclusionsSurgery for diverticular disease of the esophagus has been associated with high rates of morbidity and mortality. Despite the lethal non-surgical complication we encountered, with regard to recent publications minimally invasive apporaches to treat patients with symptomatic esophageal diverticula entail lower rates of complications with better long term results in comparison to open surgery.

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“…They reported an overall complication rate of 45% including four leakages and one intraoperative perforation (31). Rates for postoperative leakages vary between 0% and 33% (32). Within a total of 10 different retrospective studies covering 92 patients there have been 12 leakages (13.0%) (33).…”

Section: Discussionmentioning

confidence: 99%

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

Gîndea¹,

Constantin²,

Hoara³

et al. 2018

chr

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RezumatIntroducere: Diverticulul esofagian toracic reprezintă o patologie rară, frecvent asociată cu tulburări de motilitate esofagiană. Chirurgia reprezintă singura opţiune terapeutică la pacienţii cu simptome severe. Metodă: Studiu retrospectiv pe un lot de 10 pacienţi ce au suferit diverticulectomie pentru simptomatologia provocată de diverticulii epifrenici sau medio-toracici. Au fost înregistrate principalele simptome preoperatorii, analizele de sânge uzuale, tranzitul baritat, endoscopia superioară şi manometria esofagiană. Am analizat complicaţiile postoperatorii, durata de spitalizare şi perioada petrecută la terapie intensivă. Rezultate: Majoritatea pacienţilor au prezentat regurgitaţii, disfagie sau ambele. Abordul chirurgical a fost prin toracotomie stângă sau pe cale abdominală pentru diverticulii epifrenici şi prin toracotomie dreaptă sau toracoscopie pentru diverticulii mediotoracici. 4 pacienţi au prezentat complicaţii severe: 3 fistule majore (un deces) şi un chilotorax. Discuţii: Chirurgia diverticulilor toracici este asociata cu rate mari de mobiditate şi mortalitate. Fistula produsă la nivelul liniei de sutură este cea mai frecventa complicaţie, spre deosebire de chilotorax ce survine mai rar. Concluzii: Diverticulul esofagian toracic voluminos este o patologie benignă cu complicaţii "maligne". O evaluare preoperatorie Chirurgia, 113 (1), 2018 www.revistachirurgia.ro 145

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Minimally Invasive Surgery Combined With Peroperative Endoscopy for Symptomatic Middle and Lower Esophageal Diverticula

Abstract: Esophageal diverticula are rare conditions, and minimally invasive surgery is certainly feasible and effective in terms of reduced morbidity.

Cited by 29 publications

References 14 publications

Modern pathophysiology and treatment of esophageal diverticula

Modern pathophysiology and treatment of esophageal diverticula

MIS approach for diverticula of the esophagus

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

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