Alison E Brandeis1, Saurabh Singhal2, Tommy H Lee3, Sumeet K Mittal4. 1. Creighton University School of Medicine, Omaha, NE, 68131, USA. 2. Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 85013, USA. 3. Arrowhead Regional Medical Center, Colton, CA, 92324, USA. 4. Creighton University School of Medicine, Omaha, NE, 68131, USA; Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 85013, USA. Electronic address: Sumeet.Mittal@DignityHealth.org.
Abstract
BACKGROUND: We present single-center experience of surgery for primary epiphrenic diverticulum (PED) over a 12-year period. METHODS: Prospectively maintained database was queried to identify patients who underwent PED surgery. Preoperative and postoperative symptoms, operative data, perioperative complications, and follow-up were reviewed. RESULTS: Twenty-seven patients (14 females; mean age-67-years) underwent PED surgery. The most common primary presenting symptoms were dysphagia and regurgitation (mean duration-3.6-years). 82% patients underwent laparoscopic procedures (one conversion), 11% operated via left thoracotomy and 7% via combined laparoscopy-right trans-thoracic approach. All patients received myotomy, all but one received diverticulectomy. Five-patients experienced intraoperative complications that were managed intraoperatively without sequelae. There was no perioperative mortality. Morbidity was seen in 3-patients, including one staple-line leak managed with endoscopic washes and stent placement. 90% patients with ≥1-year follow-up reported "excellent" satisfaction. CONCLUSIONS: Minimally invasive surgery for PED is both feasible and safe. We observed low morbidity, short hospital stay, and excellent patient-reported outcomes.
BACKGROUND: We present single-center experience of surgery for primary epiphrenic diverticulum (PED) over a 12-year period. METHODS: Prospectively maintained database was queried to identify patients who underwent PED surgery. Preoperative and postoperative symptoms, operative data, perioperative complications, and follow-up were reviewed. RESULTS: Twenty-seven patients (14 females; mean age-67-years) underwent PED surgery. The most common primary presenting symptoms were dysphagia and regurgitation (mean duration-3.6-years). 82% patients underwent laparoscopic procedures (one conversion), 11% operated via left thoracotomy and 7% via combined laparoscopy-right trans-thoracic approach. All patients received myotomy, all but one received diverticulectomy. Five-patients experienced intraoperative complications that were managed intraoperatively without sequelae. There was no perioperative mortality. Morbidity was seen in 3-patients, including one staple-line leak managed with endoscopic washes and stent placement. 90% patients with ≥1-year follow-up reported "excellent" satisfaction. CONCLUSIONS: Minimally invasive surgery for PED is both feasible and safe. We observed low morbidity, short hospital stay, and excellent patient-reported outcomes.