Tailored surgery for esophageal body diverticula1

Castrucci, G; Porziella, Venanzio; Granone, P.; Picciocchi, Aurelio

doi:10.1016/s1010-7940(98)00201-2

Cited by 47 publications

(45 citation statements)

References 10 publications

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“…Diverticula in asymptomatic patients are largely incidental findings. Asymptomatic patients have been followed up to determine outcome; however, these numbers are small [11,[22][23][24][25][26]. Currently, there are insufficient data in the literature to help predict the natural history of asymptomatic patients [5].…”

Section: Indications For Treatmentmentioning

confidence: 99%

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Sonbare

2013

Indian J Surg

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Oesophageal diverticulum is divided into two types based on the aetiology: the pulsion and the traction diverticula. Pulsion diverticulum occurs due to increased intraluminal pressure. This can be of three types based on the location along the oesophagus: the Zenker's diverticulum (ZD), the midoesophageal diverticulum (MD) and the epiphrenic diverticulum (ED). A PubMed search was conducted for the words 'pulsion', 'diverticulum' and 'oesophagus' for all studies published from January 1980 to March 2013 in the English language. A total of 31 studies were identified, and out of which, five were not included in the review. The pulsion diverticulum of the oesophagus is an uncommon disorder. Its aetiology is related to the motility disorders of the oesophagus. Patients usually present with chest-related symptoms or oesophageal symptoms, which are related to the underlying motility disorder. Evaluation includes barium studies, gastrointestinal endoscopy, CT scan and oesophageal manometry. Surgery is the treatment of choice for symptomatic and large diverticula, although the outcome in asymptomatic patients is unknown. The surgical options include diverticulectomy or diverticulopexy with an adequate myotomy. Most patients with ZD are now treated by using endoscopic techniques, although no randomised trial has shown its superiority over the open technique. Minimally invasive surgery has also been used for patients with MD and ED. Although isolated case series has shown good improvement in symptoms and reduction in mortality with minimally invasive techniques in patients with ED, its role in thoracic oesophageal diverticulum is debated.

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Section: Indications For Treatmentmentioning

confidence: 99%

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Sonbare

2013

Indian J Surg

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“…Midesophageal diverticula have also been reported in cases of anthracosis, sarcoidosis, histoplasmosis, and lymphoma, all with a presumed similar pathogenesis [190]. Over the past 50 years, it has become recognized that the majority of both midesophageal and epiphrenic diverticula are seen in conjunction with esophageal dysmotility [191][192][193][194][195]. They are typically referred to as pulsion-type diverticula, caused by increased intralumenal pressure induced by high-amplitude or simultaneous esophageal body contractions or failed LES relaxation.…”

Section: Midesophageal and Epiphrenic Diverticulamentioning

confidence: 99%

Esophagus: anatomy and developmental and structural anomalies

Hirano

2008

Textbook of Gastroenterology

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“…[10][11][12][13] Nowadays, there is no consensus on the type of surgical access, the length of the myotomy or the type of antirefl ux technique. [1,7,14,[16][17][18][19][20][21] The conventional surgical procedure that was usually performed consisted a left thoracotomy, di-verticulectomy, myotomy and a Belsey Mark IV procedure, nonetheless, this treatment implicates a non-negligible morbidity rate reaching up to 20-25% of patients, the most important one being suture line leakage and a mortality up 5%.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive therapy of epiphrenic diverticula: Systematic review of the literature and report of 6 cases

Calatayud¹

2017

Laparosc Endosc Surg Sci

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Epiphrenic diverticula is an uncommon disease, and conventional surgical treatment entails aggressive open or transthoracic surgery. Minimally invasive treatment has changed the surgical approach, but a number of surgical controversies remain unresolved. The present study is a description of our experience with minimally invasive treatment of epiphrenic diverticula and a systematic review of the current literature on this subject. All data from the Hospital de Sant Pau were reviewed to identify patients who underwent minimally invasive treatment for epiphrenic diverticulum since 1998. In addition, systematic literature review focused on minimally invasive approach for epiphrenic diverticula was performed. Total of 6 patients have been treated (6 transhiatal and 1 with abdominal and thoracic approach) at the hospital. Predominance of male patients was observed, with median age of 63 years. Diagnosis was made with endoscopy, barium swallow, or manometry. Half of manometry results where pathological. Surgical techniques applied were diverticulectomy, myotomy, and Dor partial fundoplication. Two patients with suture line leakage were treated conservatively. No mortality was reported. Systematic literature review was conducted using the PRISMA scheme, and 21 studies with 189 patients were found. No comparative or prospective randomized trials were located. Overall morbidity rate was 24%, suture line leakage rate was 12%, hospital stay was 5 days, and mortality rate of 1.5% in the literature. After median follow up of 42 months, 81.5% of the patients were asymptomatic. Minimally invasive approach for epiphrenic diverticula is a safe and feasible procedure.

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Tailored surgery for esophageal body diverticula1

Cited by 47 publications

References 10 publications

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Esophagus: anatomy and developmental and structural anomalies

Minimally invasive therapy of epiphrenic diverticula: Systematic review of the literature and report of 6 cases

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