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Langenbeck's Archives of Surgery

, Volume 397, Issue 1, pp 29–35 | Cite as

Modern pathophysiology and treatment of esophageal diverticula

  • Fernando A. M. Herbella
  • Marco G. Patti
Review Article

Abstract

Introduction

Esophageal diverticula are rare. They may occur in the pharyngoesophageal area (Zenker's), midesophagus, or distally (epiphrenic). A motility disorder (either at the level of the esophageal sphincters or body) is frequently associated with esophageal diverticula. The risk of malignant transformation is low.

Methods

A literature search was performed using Medline/PubMed database.

Results

The treatment of esophageal diverticula must be based on the pathophysiology and natural history of the disease: (a) asymptomatic diverticula do not need a specific treatment, (b) small diverticula may be left in place and not resected, (c) medium-size diverticula may be either treated by diverticulectomy, diverticulopexy, or esophagodiverticulostomy in case of pharyngoesophageal diverticula, (d) resection is probably the ideal therapy for larger diverticula, and (e) a myotomy should always be included to the procedure.

Conclusions

Due to its rarity, esophageal diverticula must be treated by esophageal surgeons since even in experienced hands the complication rate can be significant.

Keywords

Esophagus Diverticulum Motor disorder Cancer Zenker Epiphrenic 

Notes

Conflicts of interest

None.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Surgery, Escola Paulista de MedicinaFederal University of Sao PauloSao PauloBrazil
  2. 2.Department of SurgeryUniversity of ChicagoChicagoUSA
  3. 3.Surgical Gastroenterology, Division of Esophagus and StomachHospital Sao PauloSao PauloBrazil

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