Optimal surgical approaches for esophageal epiphrenic diverticulum: literature review and our experience

被引:6
作者
Sato, Yuta [1 ]
Tanaka, Yoshihiro [1 ]
Ohno, Shinya [1 ]
Endo, Masahide [1 ]
Okumura, Naoki [1 ]
Takahashi, Takao [1 ]
Matsuhashi, Nobuhisa [1 ]
机构
[1] Gifu Grad Sch Med, Dept Gastroenterol Surg & Pediat Surg, 1-1 Yanagido, Gifu, Gifu 5011194, Japan
关键词
Epiphrenic diverticulum; Esophageal diverticulum; Diverticulectomy; Myotomy; Fundoplication; MINIMALLY INVASIVE SURGERY; ACHALASIA; MANAGEMENT; RESECTION; REPAIR;
D O I
10.1007/s12328-023-01765-2
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Esophageal epiphrenic diverticulum is a rare condition usually secondary to a primary esophageal motility disorder. Although epiphrenic diverticulum may be treated by thoracoscopic and laparoscopic management, the optimal surgical approach have not been established. We successfully treated a left epiphrenic diverticulum along with achalasia and paraesophageal hernia by a planned combination of thoracoscopic and laparoscopic procedures aided by preoperative simulation using three-dimensional imaging. We reviewed a series of 17 reports on esophageal epiphrenic diverticulum that required either planned or unplanned unexpected transthoracic surgery. The main reasons for requiring a transthoracic approach were adhesions, site and size of the diverticulum, and length of the diverticulum neck. Unplanned procedure changes were required in 12 of the 114 cases for a conversion rate of 10.5%. Diverticulectomy, myotomy, and fundoplication were the most common surgical treatments administered at 42.6%. Based on literature review and our experience, we have developed a flowchart to identify the characteristics of epiphrenic diverticulum cases that require a transthoracic approach. This flowchart can help to determine therapeutic strategies and the optimal surgical approach to esophageal epiphrenic diverticulum treatment and may reduce unplanned changes in the surgery.
引用
收藏
页码:317 / 324
页数:8
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