Korean J Thorac Cardiovasc Surg.  2019 Aug;52(4):227-231. 10.5090/kjtcs.2019.52.4.227.

The Abdominal Approach for Epiphrenic Esophageal Diverticulum as an Alternative to the Thoracic Approach

• Kim S
• Cho JH

• KMID: 2455148
• DOI: http://doi.org/10.5090/kjtcs.2019.52.4.227

Abstract

BACKGROUND
There is no established surgical procedure for the treatment of epiphrenic esophageal diverticulum. The aim of this study was to compare the clinical outcomes of esophageal diverticulectomy using abdominal and thoracic approaches.
METHODS
We retrospectively reviewed 30 patients who underwent esophageal diverticulectomy through the thoracic or abdominal approach for an epiphrenic diverticulum at a single center between 1996 and 2018. We compared clinical outcomes, including the postoperative length of stay, time from the operation to oral feeding, leakage rate, and reoperation rate between the 2 groups.
RESULTS
The median age was 56 years. Of the 30 patients, 18 (60%) underwent diverticulectomy via the thoracic approach and 12 (40%) underwent the abdominal approach. The median hospital stay was 10 days (range, 5-211 days) in the thoracic approach group and 9.5 days (range, 5-18 days) in the abdominal approach group. The median time from the operation until oral feeding was 6.5 days (range, 3-299 days) when the thoracic approach was used and 5 days (range, 1-11 days) when the abdominal approach was used. In the thoracic approach group, the leakage rate was 16.67% and the reoperation rate was 27.78%. However, there were no cases of leakage or reoperation in the abdominal approach group.
CONCLUSION
The abdominal approach for esophageal diverticulectomy is a feasible and appropriate alternative to the thoracic approach.

Keyword

Epiphrenic esophageal diverticulum; Abdominal approach; Thoracic approach; Laparoscopy; Transhiatal approach

MeSH Terms

Diverticulum
Diverticulum, Esophageal*
Humans
Laparoscopy
Length of Stay
Reoperation
Retrospective Studies