Laparoscopic repair of epiphrenic diverticulum

Abstract

Epiphrenic diverticulum of the esophagus is an uncommon disease, and its pathogenesis remains unclear. Surgical repair of this disease is warranted only for symptomatic patients because treatment carries high risk of morbidity. Over the past decade, the laparoscopic approach to epiphrenic diverticulectomy has been shown to be safe and effective. The aim of the study was to describe our specific approach to the procedure and results. From 1994 to 2012, 30 patients with symptomatic epiphrenic diverticulum underwent laparoscopic surgery. There were no conversions to open surgery. The postoperative course was uneventful in 28 patients (93.3%). One patient had a suture line leak, which required repair through right thoracotomy, and 1 patient had a hemoperitoneum, which needed an open splenectomy. The median follow-up was 52 months (2-144). To date, no patient has presented with a recurrence. Laparoscopic transhiatal surgery is in our opinion the preferred approach to treatment of epiphrenic diverticulum of the esophagus. The procedure has proven to be feasible and safe in experienced hands. Long-term results, both clinical and with an objective evaluation, are satisfactory.