Minimally invasive surgery for esophageal epiphrenic diverticulum: The results of 133 patients in 25 published series and our experience

Yuki Hirano, Hiroya Takeuchi, Takashi Oyama, Yoshirou Saikawa, Masahiro Niihara, Hiroyuki Sako, Kenshi Omagari, Tomohiko Nishi, Hidekazu Suzuki, Toshifumi Hibi, Yuko Kitagawa

Research output: Contribution to journalReview article

17 Citations (Scopus)

Abstract

Esophageal epiphrenic diverticula are uncommon. Traditionally, thoracotomy has been the preferred surgical approach. Recently, minimally invasive approaches have been reported in a few series. However, the best surgical approach remains uncertain. In this study, we review the results of 25 articles discussing laparoscopic or thoracoscopic surgery. From January 1995 to December 2008, there were a total of 133 patients reported in English-language journals in PubMed. Nineteen patients (14%) underwent thoracoscopic surgery, 112 (84%) laparoscopic surgery and two patients (2%) were treated using a combination approach. The diverticulectomy was performed using an endostapler device in all patients. A myotomy was added in 103 patients (83%). A fundoplication was added in 106 patients (85%). There were two deaths during surgery (2%). The post-operative morbidity rate was 21%. The most severe complication was suture-line leakage, which occurred in 20 patients (15%). Recently, we successfully treated a patient with an epiphrenic esophageal diverticulum by performing a minimally invasive laparoscopic transhiatal resection and Heller myotomy with Dor fundoplication after observing its enlargement on radiological and endoscopic examinations over 2years. We believe laparoscopic transhiatal resection and Heller myotomy with Dor fundoplication may therefore become the standard treatment modality for minimally invasive surgery for esophageal epiphrenic diverticulum.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalSurgery today
Volume43
Issue number1
DOIs
Publication statusPublished - 2013 Jan

Keywords

  • Achalasia
  • Epiphrenic diverticulum
  • Laparoscopy
  • Thoracoscopy
  • Transhiatal approach

ASJC Scopus subject areas

  • Surgery

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    Hirano, Y., Takeuchi, H., Oyama, T., Saikawa, Y., Niihara, M., Sako, H., Omagari, K., Nishi, T., Suzuki, H., Hibi, T., & Kitagawa, Y. (2013). Minimally invasive surgery for esophageal epiphrenic diverticulum: The results of 133 patients in 25 published series and our experience. Surgery today, 43(1), 1-7. https://doi.org/10.1007/s00595-012-0386-3