Epiphrenic Diverticulum: 20-Year Single-Institution Experience

Epiphrenic diverticula are pulsion-type outpouchings of the distal esophagus associated with motility disorders. They can present with chronic symptoms of dysphagia, regurgitation, reflux, and aspiration. A prospectively collected surgical outcomes database was queried for patients who underwent sur...

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Bibliographic Details
Published in:The American surgeon 2018-07, Vol.84 (7), p.1159-1163
Main Authors: Kao, Angela M., Arnold, Michael R., Schlosser, Kathryn A., Siddiqui, Sania L., Prasad, Tanushree, Colavita, Paul D., Heniford, B. Todd
Format: Article
Language:English
Subjects:
Achalasia
Demographics
Demography
Diverticulum
Dysphagia
Endoscopy
Esophagus
Hypertension
Laparoscopy
Morbidity
Motility
Patients
Pneumonia
Regurgitation
Surgeons
Surgery
Surgical outcomes
Surgical techniques
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Summary:Epiphrenic diverticula are pulsion-type outpouchings of the distal esophagus associated with motility disorders. They can present with chronic symptoms of dysphagia, regurgitation, reflux, and aspiration. A prospectively collected surgical outcomes database was queried for patients who underwent surgical treatment of epiphrenic diverticula at a single institution between August 1997 and August 2018. Patient demographics, presenting symptoms, operative intervention, and perioperative data were retrospectively reviewed. Twenty-seven patients with a symptomatic epiphrenic diverticulum were identified. Abnormal esophageal motility was diagnosed in 16 patients (59.2%), most commonly achalasia (29.6%). All patients had a minimally invasive (26 laparoscopic, one thoracoscopic) diverticulectomy with no conversions to open required. Concurrent myotomy was performed in 88.9 per cent patients and anti-reflux procedure in 85.2 per cent patients. There was minimal morbidity with no esophageal leaks, mortalities, or recurrent diverticula noted after 35.8 months of follow-up. Dysphagia was the most common persistent symptom and occurred in 11.1 per cent; overall resolution of symptoms was achieved with surgery in 89.9 per cent of patients. As minimally invasive techniques have advanced, laparoscopic diverticulectomy seems to be an excellent surgical approach for symptomatic epiphrenic diverticula. Long-term resolution of symptoms was achieved in most patients, with a very low complication rate.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481808400730