Surgical Therapy of the Epiphrenic Diverticulum - A Single Center Experience Over 12 Years

Betzler CP1#, Plum PS2#, Rebholz AW2, Pelzner K2, Brinkmann S2,3, Fuchs H2, Schröder W2, Bruns C2, Gutschow CA3 and Leers JM2*

1Department of Plastic and Aesthetic Surgery, Hand Surgery and Reconstructive Surgery, St. Antonius Hospital Eschweiler, Germany
2Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Germany
3Department of General, Visceral and Vascular Surgery, Marien Hospital Herne, Ruhr University Bochum, Germany
4Department of Visceral and Transplantation Surgery, University Hospital Zurich, Switzerland
#These authors contributed equally to this work

^*Correspondance to: Jessica M Leers 

 PDF  Full Text DOI: 10.25107/2474-1647.3548

Abstract

to an outpouching of the mucosal and submucosal layers, causing symptoms such as dysphagia and heartburn. Aim of this study was the retrospective evaluation of symptoms, quality of life and postsurgical complications among patients with epiphrenic diverticulum receiving surgical treatment. Methods: Twenty three patients diagnosed with esophageal diverticulum were retrospectively included into this study. Main outcome parameters were symptoms, quality of life and post-surgical complications. Results: Preoperative symptoms included dysphagia (83.34%), regurgitation (50%) and heartburn (27.8%). Twenty patients underwent surgery: Fourteen had a diverticulectomy, one received a diverticulopexy, three underwent esophagectomy and two received a single myotomy. An additional myotomy was performed in eight patients. Among patients undergoing surgical treatment, rates of heartburn, regurgitation or dysphagia were decreased. In 7 patients who underwent surgery, postsurgical complications occurred: four patients showed mild complications according to Clavien- Dindo I, one patient suffered from severe complications according to Clavien-Dindo IV a and two patients died (Clavien-Dindo V) due to sepsis and multiorgan failure. Conclusion: Our study suggests, that diverticulectomy (with/without myotomy) might be an effective surgical treatment leading to an improvement of symptoms and quality of life among patients with epiphrenic diverticulum. Still, the operative treatment is accompanied by considerable perioperative morbidity and should only be performed in carefully selected patients in experienced centers. Furthermore, minimally invasive procedures are associated with better post-operative outcomes compared to open procedures.

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Cite the article

Betzler CP, Plum PS, Rebholz AW, Pelzner K, Brinkmann S, Fuchs H, et al. Surgical Therapy of the Epiphrenic Diverticulum - A Single Center Experience Over 12 Years. Clin Surg. 2022; 7: 3548..