Two Cases of Thoracoscopic Resection of Esophageal Duplication in Children

Abstract

We report two cases of thoracoscopic resection of esophageal duplication cysts. Both patients underwent successful thoracoscopic excision. They were discharged on postoperative day 2 and 4, respectively. They made uneventful recoveries and were completely asymptomatic at 1-month followup. One child was lost to long-term follow-up. In the other child, barium swallow study 10 months after surgery demonstrated a pseudodiverticulum at the site of cyst excision. Thoracoscopic resection of esophageal duplications is safe. Complete excision is possible even if the cyst shares a common muscular wall with the esophagus. Pseudodiverticulum may develop at the site of excision: follow- up is necessary and consideration should be given to closure of the muscular defect at the time of excision. To help avoid esophageal injury and, should it occur, recognize esophageal perforation, we recommend performing the dissection under intraesophageal endoscopic supervision.

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

“…With regard to thoracoscopic resection, previous studies suggested enucleation of the cyst by electrocauterization or harmonic scalpel [1,8,9]. In our case, cystectomy was performed using endo-staplers.…”

Laparoscopic Excision of an Esophageal Duplication Cyst

“…10 Presenting symptoms may include those of either respiratory or intestinal origin, including compression of the esophagus or trachea due to mass effect, pain, infection, bleeding, or perforation. 2,11 Most studies report the finding of a duplication cyst to be an unexpected finding in patients presenting with symptoms suggestive of acute appendicitis, intussusception, intestinal obstruction, or gastrointestinal hemorrhage. In many series, however, enteric cysts are asymptomatic and discovered incidentally on imaging or at the time of surgery for other indications.…”

“…6,7 Complete excision is the treatment of choice for both symptomatic and asymptomatic, incidentally discovered esophageal duplication cysts. 2,6,12,13 Observation of these lesions should be discouraged given the potential for increasing size and compression of adjacent organs, bleeding, perforation, and malignant transformation. 2,6,12,14 Incomplete excision, needle aspiration, and marsupialization may all be complicated by unacceptably high rates of recurrence.…”

“…2,6,12,13 Observation of these lesions should be discouraged given the potential for increasing size and compression of adjacent organs, bleeding, perforation, and malignant transformation. 2,6,12,14 Incomplete excision, needle aspiration, and marsupialization may all be complicated by unacceptably high rates of recurrence. 2 To achieve complete excision, a defect in the muscular layer of the esophageal wall is required given their integral relationship.…”

“…1 Thoracoscopic resection of esophageal duplication cysts has been well described and is a common approach to these anomalies when they occur in the thoracic or mediastinal cavities. [1][2][3][4][5] Excision of esophageal duplication cysts through laparoscopy has also been described in adults, 6,7 and in 1 previous case report in a child. 4 We describe the case of a 2-year-old boy in which an esophageal duplication cyst was incidentally discovered and completely excised during laparoscopy for fundoplication.…”