Surgical Treatment of the Esophageal Diverticulum

Purpose: Clinical presentation and surgical results of the esophageal diverticula were analyzed. Methods: Ten patients who underwent esophageal diverticulectomy with myotomy from May 1999 to May 2008 were reviewed retrospectively. Results: Three pharyngoesophageal, one midesophageal and six epiphrenic diverticula were observed and transcervical, right transthoracic and left transthoracic surgical approach were used respectively. All of these cases were pulsion type and diverticulectomy with esophageal myotomy were done. For those who had leiomyoma, enucleation was performed simultaneously. One postoperative leakage was observed and resolved with conservative management. At 3 months after surgery, all patients enjoyed satisfactory results except two patients. One patient still suffered dysphagia which was not improved after surgery and the other patient had asymptomatic gastroesophageal reflux disease which was found on the follow up esophagography. Conclusion: Crucial factors in the treatment of esophageal diverticulum are high index of suspicion indicated by clinical symptoms, differential diagnosis with other disease and confirmatory diagnosis with esophagography. Diverticulectomy with esophageal myotomy is an essential procedure for the low recurrence of diverticulum.

[1]  D. Predescu,et al.  [Surgical treatment of esophageal diverticula]. , 2011, Chirurgia.

[2]  Shih-Chieh Lin,et al.  Squamous Cell Carcinoma in a Large Epiphrenic Esophageal Diverticulum , 2009, Digestive Diseases and Sciences.

[3]  M. Orringer,et al.  Surgical treatment of epiphrenic diverticula: a 30-year experience. , 2007, The Annals of thoracic surgery.

[4]  N. Surgery,et al.  A Case of Zenker's Diverticulum Mimicking the Thyroid Tumor Associated with Vocal Cord Palsy , 2006 .

[5]  P. Devitt,et al.  Evolution of surgical treatment for pharyngeal pouch , 2004, The British journal of surgery.

[6]  James I. Cohen,et al.  Current trends in management of Zenker diverticulum , 2003, Current opinion in otolaryngology & head and neck surgery.

[7]  D. W. Choi,et al.  Endoscopic Treatment of a Giant Mid-Esophageal Diverticulum. , 2002 .

[8]  E. Genden,et al.  Endoscopic stapling technique for the treatment of Zenker diverticulum vs standard open-neck technique: a direct comparison and charge analysis. , 2002, Archives of otolaryngology--head & neck surgery.

[9]  김동관,et al.  양성 식도질환에서 개흉술과 비디오 흉강경을 이용한 수술 성적의 비교 , 2000 .

[10]  C. Pellegrini,et al.  Minimally invasive treatment of esophageal diverticula. , 1999, Seminars in thoracic and cardiovascular surgery.

[11]  Randall Morton,et al.  Inversion of Zenker's diverticulum: The preferred option , 1993, Head & neck.

[12]  P. Pairolero,et al.  Epiphrenic diverticulum: results of surgical treatment. , 1993, The Annals of thoracic surgery.

[13]  이동준,et al.  식도게실의 외과적 치료 , 1992 .

[14]  김명욱,et al.  근위부 담도암의 치료성적 , 1992 .

[15]  J. Dent,et al.  Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening. , 1992, Gastroenterology.

[16]  김주현.  식도게실의 외과적 치료 , 1989 .

[17]  김근호,et al.  식도게실의 외과적 치료에 대한 임상적 고찰 , 1989 .

[18]  I. Hong,et al.  Radiological evaluation of G-I tract diverticulum in Korean , 1986 .

[19]  Q. Z. Wang,et al.  Carcinoma in the esophageal diverticulum. , 1985, Chinese medical journal.

[20]  S. Etani,et al.  Surgical Treatment of Esophageal Diverticulum , 1981 .

[21]  Seaman Wb,et al.  Epiphrenic diverticula. An analysis of 80 cases. , 1973 .

[22]  W. Seaman,et al.  Epiphrenic diverticula. An analysis of 80 cases. , 1973, The American journal of roentgenology, radium therapy, and nuclear medicine.

[23]  F. Ellis,et al.  Cricopharyngeal Myotomy for Pharyngo‐Esophageal Diverticulum , 1969, Annals of surgery.

[24]  B. Petrov.  [Surgery of the esophagus]. , 1967, Khirurgiia.

[25]  S. W. Law,et al.  PULSION DIVERTICULA OF THE MID-THORACIC ESOPHAGUS. , 1964, The Journal of thoracic and cardiovascular surgery.

[26]  R. Sweet.  Excision of Diverticulum of the Pharyngo‐Esophageal Junction and Lower Esophagus by Means of the One Stage Procedure , 1956, Annals of surgery.

[27]  F. Lahey.  Pharyngo-esophageal Diverticulum: Its Management and Complications. , 1946, Annals of surgery.