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Videothoracoscopic resection of an esophageal diverticulum Mid and low third pulsion esophageal epiphrenic diverticula require surgical treatment. Yuxta cardial diverticula can be approached by a trans hiatal approach, but higher situation requires a thoracic approach. Case report: A 52 year old man complaining of severe pirosis and thoracic pain oesophagogastric Rx series showed a hiatal sliding hernia, oesophagogastric reflux and a 5 cm. Esophageal diverticulum located in the upper part of the lower third of the esophagus. Manometry ruled out the existence of a motor disturbance and a pathologic ph-metry. The patient was approached trough the abdomen, an a transhiatal dissection was tried but the diverticula was too high for a safe resection, and a crural closure and Toupet partial plication was done. The GERD symptoms disappeared but thoracic pain persisted, and 3 months later, a videothoracoscopic resection of the diverticulum was proposed. The right thorax was approached through a 5 cm minithoracotomy and two 5 mm trocars. The diverticulum was located at the mid-lower third union of the oesophagus. Dissection permit to clearly view the neck of the sac, and transection with mechanical suture (Surg Assist) was done. Staple line was reinforced with esophageal muscular closure and a chest drain was placed. Esophagogram three days later ruled out the existence of leakage, and the patient was discharged at the 5th postoperative day.

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2004-04-19   |   573 visitas   |   Evalua este artículo 0 valoraciones

Vol. 5 Núm.1. Febrero 2004 Pags. 29-45 Rev Mex Cir Endoscop 2004; Supl.(1)