Abstract
Esophageal diverticula are a rare disorder defined by the presence of diverticula of the distal 10 cm of the esophagus, near the diaphragm and gastroesophageal junction. Surgical treatment of epiphrenic diverticula was previously done via an open transthoracic approach which has been associated with high morbidity and mortality. Most can be done; however, via a laparoscopic approach, although diverticula located more superiorly on the esophagus may require a thoracoscopic approach. The procedure includes a cardiomyotomy to treat the underlying motility disorder. Small diverticula need not be resected. However, resection of larger diverticula is recommended because food can still become impacted in the diverticula.
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References
Herbella FA, Patti PG. Modern pathophysiology and treatment of esophageal diverticula. Langenbecks Arch Surg. 2012;397(1):29–35.
Thomas ML, Anthony AA, Fosh BG, Finch JG, Maddern GJ. Oesophageal diverticula. Br J Surg. 2001;88(5):629–42.
Herbella FA, Dubecz A, Patti MG. Esophageal diverticula and cancer. Dis Esophagus. 2012;25(2):153–8.
McDonald JD, Jacobs J, Saad A, Richter JE, Velanovich V. Heller myotomy for epiphrenic diverticula compared to nondiverticula esophageal motility disorders, a single institution experience and appraisal of patient characteristics, high-resolution manometry and outcomes. Dig Surg. 2020;37(1):72–80.
Triggs JR, Krause AJ, Carlson DA, Donnan EN, Campagna RAJ, Jain AS, Kahrilas PJ, Hungness ES, Pandolfino JE. Blown-out myotomy: an adverse event of laparoscopic Heller myotomy and peroral endoscopic myotomy for achalasia. Gastrointest Endosc. 2021;93(4):861-8.e1.
Fisichella PM, Jalilvand A, Dobrowolsky A. Achalasia and epiphrenic diverticulum. World J Surg. 2015;39(7):1614–9.
Jordan PH Jr, Kinner BM. New look at epiphrenic diverticula. World J Surg. 1999;23(2):147–52.
Zaninotto G, Portale G, Costantini M, Zanatta L, Salvador R, Ruol A. Therapeutic strategies for epiphrenic diverticula: systematic review. World J Surg. 2011;35(7):1447–53.
Nehra D, Lord RV, DeMeester TR, Theisen J, Peters JH, Crookes PF, Bremner CG. Physiologic basis for the treatment of epiphrenic diverticulum. Ann Surg. 2002;235:346–54.
Fasano NC, Levine MS, Rubesin SE, Redfen RO, Laufer I. Epiphrenic diverticula: clinical and radiographic findings. Dysphagia. 2003;18:9–15.
Soares R, Herbella FA, Prachand VN, Ferguson MK, Patti. Epiphrenic diverticulum of the esophagus. From pathophysiology to treatment. J Gastrointest Surg. 2010;14(12):2009–15.
D’Journo XB, Ferraro P, Martin J, Chen L-Q, Duranceau A. Lower oesophageal sphincter dysfunction is part of the functional abnormality in epiphrenic diverticulum. Br J Surg. 2009;96(8):892–900.
Tedesco P, Fisichella PM, Way LW, Patti MG. Cause and treatment of epiphrenic diverticula. Am J Surg. 2005;190(6):891–4.
Melman L, et al. Esophageal manometric characteristics and outcomes for laparoscopic esophageal diverticulectomy, myotomy, and partial fundoplication for epiphrenic diverticula. Surg Endosc. 2009;23(6):1337–41.
Patti MG, Herbella FA. Fundoplication after laparoscopic Heller myotomy for esophageal achalasia: what type? J Gastrointest Surg. 2010;14(9):1453–8.
Nabi Z, Chavan R, Asif S, Ramchandani M, Basha J, Darisetty S, Goud R, Kotla R, Reddy DN. Per-oral Endoscopic Myotomy with Division of Septum (D-POEM) in epiphrenic esophageal diverticula: outcomes at a median follow-up of two years. Dysphagia; 1 July 2021.
Richards WO, Torquati A, Holzman MD, Khaitan L, Byrne D, Lutfi R, Sharp KW. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg. 2004;240(3):405–12.
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McGee, M., Velanovich, V. (2022). Laparoscopic Treatment of Epiphrenic Diverticulum. In: Herbella, F.A.M., Patti, M.G. (eds) Atlas of Esophageal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-12790-8_11
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