R Parthasarathi, MS, FMAS, S Rajapandian, MS, FRCS, FMAS, P Senthilnathan, MS, FMAS, DNB, Subrahmaneswara Babu, P Praveen Raj, C Palanivelu, MS, FACS, FRCSEd, DSc. GEM Hospital & Research Centre
Background: Diverticula of the mid and distal esophagus are relatively rare presentations in a patient complaining of dysphagia. Management is further complicated by the underlying pathology and thus controversies still exist. In this context our objective through this study was to evaluate the outcomes of laparoscopic management of the mid and distal esophageal diverticulae and share our experience over the past seventeen years.
Methods: A retospective review of prospectively maintained database was conducted including all the patients who underwent laparoscopic surgery for symptomatic diverticula at our hospital from 1997 till 2015. All the clinico-pathological parameters, operative and post-operative parameters were recorded and analysed. Also, the quality of life in terms of dysphagia was evaluated during the follow up.
Results: Sixty eight patients (40 males, 28 females) with a mean age of 42+9.4 years underwent laparoscopic management of esophageal diverticula during the study period. The most common presentation was dysphagia (60/68, 88%) while the most common site was lower esophagus (epiphrenic diverticulum, 48/68, 71%). Laparoscopic management was done either through the trans-hiatal approach (n=34), thoracoscopic approach (n=26) or a combined approach (n=8). Post-operative leak was detected in three patients (4%) that required laparoscopic correction while there was no mortality. All the patients had significant improvement in the dysphagia during follow up.
Conclusion: Laparoscopic management of diverticula of the esophagus is faesible, safe and effective. However, this procedure is technically demanding and should be performed only by surgeons with sufficient experience advanced laparoscopic gastrointestinal surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80897
Program Number: P389
Presentation Session: Poster (Non CME)
Presentation Type: Poster
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