Thoracoscopic removal of oesophageal duplication cyst

Abstract

A 4-year-old boy presented with vomiting and recurrent cough. He was investigated and found to have thoracic oesophageal duplication cyst. He was taken up for thoracoscopic removal of the cyst. The cyst was attached to the oesophagus and shared a common wall. The boy tolerated the procedure well and follow-up showed no recurrence of the cyst with total resolution of the symptoms. We share our experience with the management of this boy.

Surgical treatment of a thoracic oesophageal duplication cyst causing recurrent dysphagia in an adult dog

“…Preoperative diagnosis can be established with standard radiological techniques, computed tomography, magnetic resonance (MR), endoscopy and endoscopic ultrasound (EUS) (Carachi and Azmy 2002;Gupta et al 2010;Agarwal and Bagdi 2011).…”

“…An oesophagogram and endoscopic scanning usually show external compression of the oesophagus, without involvement of the mucosa, while computed tomography scans clearly demonstrate the presence of a fluidfilled lesion, its exact anatomical location and the relationship with adjacent structures. In addition, CT also permits simultaneous investigation and evaluation of the spine, thoracic and mediastinal structures, thus enabling the diagnosis of possible complications of the oesophageal anomaly (Carachi and Azmy 2002;Gupta et al 2010;Agarwal and Bagdi 2011).…”

“…In human medicine, a complete surgical excision by thoracotomy or thoracoscopy is the treatment of choice and is always indicated to prevent complications (Sundaramoorthi et al 2000;Agarwal and Bagdi 2011). Leaving the cyst untreated may eventually lead to significant complications including mediastinitis, due to infection of the mediastinal cyst, life-threating haemoptysis, bronco-oesophageal fistula or more rarely, malignant transformations (Sundaramoorthi et al 2000;Carachi and Azmy 2002;Agarwal and Bagdi 2011;Obasi et al 2011).…”

“…Leaving the cyst untreated may eventually lead to significant complications including mediastinitis, due to infection of the mediastinal cyst, life-threating haemoptysis, bronco-oesophageal fistula or more rarely, malignant transformations (Sundaramoorthi et al 2000;Carachi and Azmy 2002;Agarwal and Bagdi 2011;Obasi et al 2011). In addition, surgical excision is also required for a definitive diagnosis based on histological examination of the surgical specimen.…”

“…In addition, surgical excision is also required for a definitive diagnosis based on histological examination of the surgical specimen. The surgical technique must focus on maintenance of the integrity of oesophageal mucosa, the approximation of the muscle layers and preservation of the vagus and phrenic nerves in order to avoid the development of a pseudodiverticulum, as well as cardiopulmonary and gastrointestinal complications (Martin et al 2007;Kang et al 2008, Gupta et al 2010Agarwal and Bagdi 2011;Obasi et al 2011).…”