Surgical treatment of thoracic esophageal diverticula (clinical series)

doi:https://doi.org/10.17116/dokgastro20241304189

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OBJECTIVE

To evaluate the outcomes of surgical treatment for epiphrenic (supradiaphragmatic) and bifurcational (mid-esophageal, epibronchial) esophageal diverticula.

MATERIAL AND METHODS

Between 2015 and 2022, 12 patients with epiphrenic and bifurcational esophageal diverticula were treated at the Loginov Moscow Clinical Research Center. Thoracoscopic diverticulectomy was performed in 7 cases (5 bifurcational and 2 epiphrenic), while 5 patients underwent laparoscopic transhiatal diverticulectomy. In 3 patients, surgery was supplemented with fundoplication (Toupet, Dor), and in 1 patient with cardiomyotomy.

RESULTS

No fatal outcomes were recorded. One patient developed a pneumothorax in the postoperative period, requiring pleural drainage. At follow-up, one patient continued to experience dysphagia, retrosternal pain, and regurgitation. Two patients showed negative dynamics: one experienced a recurrence of the diverticulum, and the other had worsened dysphagia.

CONCLUSIONS

Diverticulectomy for bifurcational diverticula is effective in alleviating clinical symptoms without the need for additional myotomy. Surgical treatment of epiphrenic diverticula involving diverticulectomy without fundoplication and/or cardiomyotomy does not always lead to satisfactory postoperative results, warranting further investigation.

Keywords:

esophageal diverticulum

thoracoscopic surgery

laparoscopy

fundoplication

postoperative complications

Received:

11.07.2023

Accepted:

17.06.2024

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References:

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