Minimally invasive therapy for epiphrenic diverticula: Systematic review of literature and report of six cases

Mariel Gonzalez-Calatayud, Eduardo M. Targarona, Carmen Balague, Carlos Rodriguez-Luppi, Ana B. Martin, Manuel Trias

Research output: Contribution to journalReview articleResearchpeer-review

12 Citations (Scopus)

Abstract

Introduction: Epiphrenic diverticula (ED) are infrequent and conventional surgical treatment entails aggressive open or transthoracic surgery. Minimally invasive treatment has changed the surgical approach but some surgical controversies are not resolved. Objective: The objective of this study is to describe our experience in minimally invasive treatment of the ED and to perform a systematic review of the current literature in this subject. Materials and Methods: We reviewed all data from the Hospital de Sant Pau, focusing on patients that underwent minimally invasive treatment for an ED since 1998 to date. Furthermore, we performed a systematic literature review focused on the minimally invasive approach for ED. Results: A total of 6 patients have been treated (5 transhiatal and 1 with abdominal and thoracic approach). We found a predominance of males with a median age of 63. The diagnosis was made with an endoscopy, barium swallow and manometry. Half of the manometry results were pathologic. The surgical technique involved a diverticulectomy, myotomy and a Dor partial founduplication. Two patients that presented suture line leakage (SLL) were treated conservatively. No mortality was reported. The systematic review was carried out under the Preferred Reporting Items for Systematic Reviews and Meta-analyses scheme, with a total of 20 studies where 189 patients were found. No comparative or prospective randomised trials were found. Overall morbidity was 24%, with a SLL rate of 12%, hospital stay of 5 days and mortality of 1.5%. After a median follow-up of 42 months, 81.5% of the patients were asymptomatic. Conclusion: The minimally invasive approach for ED is a safe and feasible procedure.
Original languageEnglish
Pages (from-to)169-174
JournalJournal of Minimal Access Surgery
Volume10
Issue number4
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Epiphrenic diverticula
  • minimally invasive surgery
  • oesophageal diverticulum

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