Laparoscopic approach in the treatment of epiphrenic diverticula: long-term results

Genio, A. Del; Rossetti, Gianluca; Maffettone, V.; Renzi, Adolfo; Brusciano, Luigi; Limongelli, Paolo; Cuttitta, D.; Russo, Gianluca; Genio, Gianmattia del

doi:10.1007/s00464-003-9044-6

Cited by 92 publications

(100 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Del Genio et al [18] performed Nissen-Rossetti fundoplication with an incidence of leakage of 23%, and therefore they recommend a transoperative manometry to verify the lower esophageal sphincter pressure. In Japan, the Dor fundoplication it is recommended because it is easier to perform and can potentially prevent the formation of a pseudodiverticulum or leakage if an intraoperative esophageal mucosa perforation occurs.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13] Nowadays, there is no consensus on the type of surgical access, the length of the myotomy or the type of antirefl ux technique. [1,7,14,[16][17][18][19][20][21] The conventional surgical procedure that was usually performed consisted a left thoracotomy, di-verticulectomy, myotomy and a Belsey Mark IV procedure, nonetheless, this treatment implicates a non-negligible morbidity rate reaching up to 20-25% of patients, the most important one being suture line leakage and a mortality up 5%. [22] These results and the good access to the hiatal hiatus obtained through a minimally invasive technique has favoured during last years to switch to endoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Minimally invasive therapy of epiphrenic diverticula: Systematic review of the literature and report of 6 cases

Calatayud¹

2017

Laparosc Endosc Surg Sci

View full text Add to dashboard Cite

Epiphrenic diverticula is an uncommon disease, and conventional surgical treatment entails aggressive open or transthoracic surgery. Minimally invasive treatment has changed the surgical approach, but a number of surgical controversies remain unresolved. The present study is a description of our experience with minimally invasive treatment of epiphrenic diverticula and a systematic review of the current literature on this subject. All data from the Hospital de Sant Pau were reviewed to identify patients who underwent minimally invasive treatment for epiphrenic diverticulum since 1998. In addition, systematic literature review focused on minimally invasive approach for epiphrenic diverticula was performed. Total of 6 patients have been treated (6 transhiatal and 1 with abdominal and thoracic approach) at the hospital. Predominance of male patients was observed, with median age of 63 years. Diagnosis was made with endoscopy, barium swallow, or manometry. Half of manometry results where pathological. Surgical techniques applied were diverticulectomy, myotomy, and Dor partial fundoplication. Two patients with suture line leakage were treated conservatively. No mortality was reported. Systematic literature review was conducted using the PRISMA scheme, and 21 studies with 189 patients were found. No comparative or prospective randomized trials were located. Overall morbidity rate was 24%, suture line leakage rate was 12%, hospital stay was 5 days, and mortality rate of 1.5% in the literature. After median follow up of 42 months, 81.5% of the patients were asymptomatic. Minimally invasive approach for epiphrenic diverticula is a safe and feasible procedure.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimally invasive therapy of epiphrenic diverticula: Systematic review of the literature and report of 6 cases

Calatayud¹

2017

Laparosc Endosc Surg Sci

View full text Add to dashboard Cite

show abstract

“…There were nine cases of death (6.1 %) in the open series [41]. The leak rates have been high, up to 18 % in open series [11] and 20-23 % in laparoscopic series [18,42]. Symptom relief appeared to be favourable in patients undergoing minimally invasive surgery, but the follow-up was shorter than that in the open literature [40].…”

Section: Treatmentmentioning

confidence: 99%

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Sonbare

2013

Indian J Surg

View full text Add to dashboard Cite

Oesophageal diverticulum is divided into two types based on the aetiology: the pulsion and the traction diverticula. Pulsion diverticulum occurs due to increased intraluminal pressure. This can be of three types based on the location along the oesophagus: the Zenker's diverticulum (ZD), the midoesophageal diverticulum (MD) and the epiphrenic diverticulum (ED). A PubMed search was conducted for the words 'pulsion', 'diverticulum' and 'oesophagus' for all studies published from January 1980 to March 2013 in the English language. A total of 31 studies were identified, and out of which, five were not included in the review. The pulsion diverticulum of the oesophagus is an uncommon disorder. Its aetiology is related to the motility disorders of the oesophagus. Patients usually present with chest-related symptoms or oesophageal symptoms, which are related to the underlying motility disorder. Evaluation includes barium studies, gastrointestinal endoscopy, CT scan and oesophageal manometry. Surgery is the treatment of choice for symptomatic and large diverticula, although the outcome in asymptomatic patients is unknown. The surgical options include diverticulectomy or diverticulopexy with an adequate myotomy. Most patients with ZD are now treated by using endoscopic techniques, although no randomised trial has shown its superiority over the open technique. Minimally invasive surgery has also been used for patients with MD and ED. Although isolated case series has shown good improvement in symptoms and reduction in mortality with minimally invasive techniques in patients with ED, its role in thoracic oesophageal diverticulum is debated.

show abstract

“…These results have not been modified despite the introduction of minimally invasive techniques and mechanical suture devices (21,22).…”

Section: Introductionmentioning

confidence: 99%

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

Gîndea¹,

Constantin²,

Hoara³

et al. 2018

chr

View full text Add to dashboard Cite

RezumatIntroducere: Diverticulul esofagian toracic reprezintă o patologie rară, frecvent asociată cu tulburări de motilitate esofagiană. Chirurgia reprezintă singura opţiune terapeutică la pacienţii cu simptome severe. Metodă: Studiu retrospectiv pe un lot de 10 pacienţi ce au suferit diverticulectomie pentru simptomatologia provocată de diverticulii epifrenici sau medio-toracici. Au fost înregistrate principalele simptome preoperatorii, analizele de sânge uzuale, tranzitul baritat, endoscopia superioară şi manometria esofagiană. Am analizat complicaţiile postoperatorii, durata de spitalizare şi perioada petrecută la terapie intensivă. Rezultate: Majoritatea pacienţilor au prezentat regurgitaţii, disfagie sau ambele. Abordul chirurgical a fost prin toracotomie stângă sau pe cale abdominală pentru diverticulii epifrenici şi prin toracotomie dreaptă sau toracoscopie pentru diverticulii mediotoracici. 4 pacienţi au prezentat complicaţii severe: 3 fistule majore (un deces) şi un chilotorax. Discuţii: Chirurgia diverticulilor toracici este asociata cu rate mari de mobiditate şi mortalitate. Fistula produsă la nivelul liniei de sutură este cea mai frecventa complicaţie, spre deosebire de chilotorax ce survine mai rar. Concluzii: Diverticulul esofagian toracic voluminos este o patologie benignă cu complicaţii "maligne". O evaluare preoperatorie Chirurgia, 113 (1), 2018 www.revistachirurgia.ro 145

show abstract

Laparoscopic approach in the treatment of epiphrenic diverticula: long-term results

Abstract: Laparoscopic management of epiphrenic diverticula seems to be as safe and effective as the traditional approach, although a longer follow-up period is necessary to confirm the study results.

Cited by 92 publications

References 16 publications

Minimally invasive therapy of epiphrenic diverticula: Systematic review of the literature and report of 6 cases

Minimally invasive therapy of epiphrenic diverticula: Systematic review of the literature and report of 6 cases

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

Contact Info

Product

Resources

About