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, Yoshiro Saikawa, Masahiro Niihara, Hiroyuki Sako, Kenshi Omagari, Tomohiko Nishi, Hidekazu Suzuki, Toshifumi Hibi, Yuukou Kitagawa

Research output: Contribution to journalArticle

16 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

Fingerprint

Esophageal Diverticulum
Minimally Invasive Surgical Procedures
Fundoplication
Thoracoscopy
Laparoscopy
Thoracotomy
PubMed
Sutures
Language
Morbidity
Equipment and Supplies

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

Minimally invasive surgery for esophageal epiphrenic diverticulum : The results of 133 patients in 25 published series and our experience. / Hirano, Yuki; Takeuchi, Hiroya; Oyama, Takashi; Saikawa, Yoshiro; Niihara, Masahiro; Sako, Hiroyuki; Omagari, Kenshi; Nishi, Tomohiko; Suzuki, Hidekazu; Hibi, Toshifumi; Kitagawa, Yuukou.

In: Surgery Today, Vol. 43, No. 1, 01.2013, p. 1-7.

Research output: Contribution to journalArticle

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, vol. 43, no. 1, pp. 1-7. https://doi.org/10.1007/s00595-012-0386-3
Hirano, Yuki ; Takeuchi, Hiroya ; Oyama, Takashi ; Saikawa, Yoshiro ; Niihara, Masahiro ; Sako, Hiroyuki ; Omagari, Kenshi ; Nishi, Tomohiko ; Suzuki, Hidekazu ; Hibi, Toshifumi ; Kitagawa, Yuukou. / Minimally invasive surgery for esophageal epiphrenic diverticulum : The results of 133 patients in 25 published series and our experience. In: Surgery Today. 2013 ; Vol. 43, No. 1. pp. 1-7.
@article{d07d3d7103d646f9959bc9d60d1f6d87,
title = "Minimally invasive surgery for esophageal epiphrenic diverticulum: The results of 133 patients in 25 published series and our experience",
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.",
keywords = "Achalasia, Epiphrenic diverticulum, Laparoscopy, Thoracoscopy, Transhiatal approach",
author = "Yuki Hirano and Hiroya Takeuchi and Takashi Oyama and Yoshiro Saikawa and Masahiro Niihara and Hiroyuki Sako and Kenshi Omagari and Tomohiko Nishi and Hidekazu Suzuki and Toshifumi Hibi and Yuukou Kitagawa",
year = "2013",
month = "1",
doi = "10.1007/s00595-012-0386-3",
language = "English",
volume = "43",
pages = "1--7",
journal = "Surgery Today",
issn = "0941-1291",
publisher = "Springer Japan",
number = "1",

}

TY - JOUR

T1 - Minimally invasive surgery for esophageal epiphrenic diverticulum

T2 - The results of 133 patients in 25 published series and our experience

AU - Hirano, Yuki

AU - Takeuchi, Hiroya

AU - Oyama, Takashi

AU - Saikawa, Yoshiro

AU - Niihara, Masahiro

AU - Sako, Hiroyuki

AU - Omagari, Kenshi

AU - Nishi, Tomohiko

AU - Suzuki, Hidekazu

AU - Hibi, Toshifumi

AU - Kitagawa, Yuukou

PY - 2013/1

Y1 - 2013/1

N2 - 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.

AB - 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.

KW - Achalasia

KW - Epiphrenic diverticulum

KW - Laparoscopy

KW - Thoracoscopy

KW - Transhiatal approach

UR - http://www.scopus.com/inward/record.url?scp=84871348320&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871348320&partnerID=8YFLogxK

U2 - 10.1007/s00595-012-0386-3

DO - 10.1007/s00595-012-0386-3

M3 - Article

C2 - 23086012

AN - SCOPUS:84871348320

VL - 43

SP - 1

EP - 7

JO - Surgery Today

JF - Surgery Today

SN - 0941-1291

IS - 1

ER -