Evolving Options in Management of Minimally Invasive Diverticular Disease: A Single Surgeon's Experience and Review of the Literature.

MedStar author(s):
Citation: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2019 Jan 08PMID: 30620240Institution: MedStar Washington Hospital CenterDepartment: Surgery/Thoracic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2019Local holdings: Available online through MWHC library: 2000 - 2010, Available in print through MWHC library:1999-2007ISSN:
  • 1092-6429
Name of journal: Journal of laparoendoscopic & advanced surgical techniques. Part AAbstract: BACKGROUND: Esophageal thoracic diverticular disease is a rare condition resulting from multiple etiologies. Surgical management is recommended when symptomatic. Traditionally, a thoracotomy was considered the standard approach; however, the use of minimally invasive approaches has been associated with improved outcomes.CONCLUSIONS: In experienced hands, a minimally invasive diverticulectomy is safe, effective, and associated with excellent patient outcomes. A minimally invasive approach should be performed when possible and should be tailored to the individual patient's disease and preoperative workup.METHODS: We retrospectively reviewed a single surgeon's experience with minimally invasive esophageal diverticulectomy.RESULTS: Fifteen patients with symptomatic esophageal diverticular disease underwent minimally invasive diverticulectomy between 2005 and 2018. Most patients (86.7%) had epiphrenic diverticula and 53.3% underwent a video-assisted thoracoscopic surgery approach. All patients had a diverticulectomy, while 14 patients (93.3%) also had an esophageal myotomy. Three patients (20%) underwent an extended myotomy, 4 patients (26.7%) underwent a concomitant fundoplication, and 2 patients (13.3%) underwent a concomitant paraesophageal hernia repair. Median length of hospital stay was 2 days (range, 1-16 days). There were no mortalities. Two patients (13.3%) were readmitted with delayed esophageal leaks. Median follow- up was 10.7 months (range, 10 days to 6.3 years). One patient presented with recurrent disease 5 years after his initial operation.All authors: Caso R, Chang H, Marshall MBFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2019-01-18
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30620240 Available 30620240

Available online through MWHC library: 2000 - 2010, Available in print through MWHC library:1999-2007

BACKGROUND: Esophageal thoracic diverticular disease is a rare condition resulting from multiple etiologies. Surgical management is recommended when symptomatic. Traditionally, a thoracotomy was considered the standard approach; however, the use of minimally invasive approaches has been associated with improved outcomes.

CONCLUSIONS: In experienced hands, a minimally invasive diverticulectomy is safe, effective, and associated with excellent patient outcomes. A minimally invasive approach should be performed when possible and should be tailored to the individual patient's disease and preoperative workup.

METHODS: We retrospectively reviewed a single surgeon's experience with minimally invasive esophageal diverticulectomy.

RESULTS: Fifteen patients with symptomatic esophageal diverticular disease underwent minimally invasive diverticulectomy between 2005 and 2018. Most patients (86.7%) had epiphrenic diverticula and 53.3% underwent a video-assisted thoracoscopic surgery approach. All patients had a diverticulectomy, while 14 patients (93.3%) also had an esophageal myotomy. Three patients (20%) underwent an extended myotomy, 4 patients (26.7%) underwent a concomitant fundoplication, and 2 patients (13.3%) underwent a concomitant paraesophageal hernia repair. Median length of hospital stay was 2 days (range, 1-16 days). There were no mortalities. Two patients (13.3%) were readmitted with delayed esophageal leaks. Median follow- up was 10.7 months (range, 10 days to 6.3 years). One patient presented with recurrent disease 5 years after his initial operation.

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