Thoracoscopic stapled resection of multiple esophageal duplication cysts with different pathological findings

Abstract

Esophageal duplication cyst is a rare congenital esophageal anomaly of the foregut. This cyst usually occurs in isolation, and thus far, was treated by enucleation through thoracoscopic or thoracotomic surgery. Here we report a case of multiple esophageal duplication cysts that showed different pathological findings, i.e., the cysts were lined with pseudostratified ciliated columnar and stratified squamous epithelium. Esophageal cysts were incidentally detected in a 53-year-old man during the treatment of pneumonia. In chest-computed tomography, the cysts showed a thin wall and homogeneous inner density, while in endoscopy, no communication with esophageal mucosa was observed. We resected the esophageal cysts with endo-staplers under thoracoscopic surgery. No postoperative complications, including esophageal mucosal injury, occurred. A follow-up chest computed tomography revealed the complete resection of the cysts.

Complicated Esophagal Duplication Cyst in Adult: A Case Report and Review of the Litterature

“…Compared with the open approach, VATS reduces postoperative pain, leads to earlier recovery and hospital discharge, and has a better cosmetic outcome [11,14] . In this case, we used an open approach because the patient had a poorly conditions and the duplication was complicated by pyothorax and bronchiolar fistula that the management was very difficult by VATS.…”

“…However, video-assisted thoracoscopic surgery (VATS) has recently become a viable surgical option for the excision of duplication cysts [7,11] .…”

“…Surgical resection of the cyst is usually carried out in childhood or in adults, in cases of lesions impossible to treat endoscopically. Surgical treatment is currently moving from thoracotomy to less-invasive procedures, such as video-assisted thoracoscopic surgery and to endoscopic treatments which, however, still remain challenging interventions [7,11,12] . We report a case of squamous cell carcinoma arising within an esophageal duplication cyst in adult with acute clinical presentation (perforation into thorax), treated with surgical resection.…”

“…Most cysts are resected due to active symptoms. However, cysts that are incidentally found and asymptomatic are surgically resected to prevent potential complications from untreated duplication cysts [9][10][11] . Treatment of symptomatic esophageal cysts can be either surgical or endoscopic.…”

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

“…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).…”