Long-term results of minimally invasive surgery for symptomatic epiphrenic diverticulum

Rosati, Riccardo; Fumagalli, Uberto; Elmore, Ugo; Pascale, Stefano De; Massaron, Simonetta; Peracchia, A.

doi:10.1016/j.amjsurg.2010.03.016

Cited by 54 publications

(57 citation statements)

References 19 publications

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“…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. [40] Regarding the complications rate, Rosati et al [1] associated the risk of suture line leakage with the size of the diverticulum (more than 9 cm) and Zaninotto et al [24] with the use of more than one stapling shot.…”

Section: Discussionmentioning

confidence: 99%

“…Rosati et al [1] prefer the Dor fundoplication for GERD patients and Toupet for those who did not have it; and Klaus [14] Nissen for those with normal motility and Toupet for abnormal ones. Tedesco [16] is in favor of the Dor fundoplication in all patients and Fernando [25] only in patients with a history of GERD, hiatal hernia or wide hiatal dissection.…”

Section: Preoperative Characteristicsmentioning

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%

“…[1,2] There is an estimated prevalence of 0.015% in the United States, 0.77% in Japan and up to 2% in Europe. [3][4][5][6][7][8] In 1998, Rosati et al [9] was the first surgeon to perform a minimally invasive transhiatal access for epiphrenic diverticulum (ED) on a patient.…”

Section: Introductionmentioning

confidence: 99%

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

Calatayud¹

2017

Laparosc Endosc Surg Sci

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Preoperative Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Calatayud¹

2017

Laparosc Endosc Surg Sci

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“…Evaluation of esophageal motility is the only way to quantify the etiopathogeny substrate of diverticular pouch development and to decide the therapeutic protocol (8,9).…”

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

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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

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Treatment of Epiphrenic Diverticula

Fisichella

Hiranyatheb

Ferguson

2013

Surgical Management of Benign Esophageal Disorders

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Long-term results of minimally invasive surgery for symptomatic epiphrenic diverticulum

Cited by 54 publications

References 19 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

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

Treatment of Epiphrenic Diverticula

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