Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia?
Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is perform...
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| Autor*in: |
Allaix, Marco E. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2014 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2014 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 39(2014), 1 vom: 05. Sept., Seite 203-207 |
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| Übergeordnetes Werk: |
volume:39 ; year:2014 ; number:1 ; day:05 ; month:09 ; pages:203-207 |
| Links: |
|---|
| DOI / URN: |
10.1007/s00268-014-2770-1 |
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SPR003449637 |
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| 520 | |a Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. | ||
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| 700 | 1 | |a Herbella, Fernando A. |4 aut | |
| 700 | 1 | |a Fisichella, Piero M. |4 aut | |
| 700 | 1 | |a Patti, Marco G. |4 aut | |
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10.1007/s00268-014-2770-1 doi (DE-627)SPR003449637 (SPR)s00268-014-2770-1-e DE-627 ger DE-627 rakwb eng Allaix, Marco E. verfasserin aut Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. Achalasia (dpeaa)DE-He213 Esophageal Manometry (dpeaa)DE-He213 Heller Myotomy (dpeaa)DE-He213 Staple Line Leak (dpeaa)DE-He213 Epiphrenic Diverticulum (dpeaa)DE-He213 Borraez Segura, Bernardo A. aut Herbella, Fernando A. aut Fisichella, Piero M. aut Patti, Marco G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2014), 1 vom: 05. Sept., Seite 203-207 (DE-627)SPR003391159 nnns volume:39 year:2014 number:1 day:05 month:09 pages:203-207 https://dx.doi.org/10.1007/s00268-014-2770-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2014 1 05 09 203-207 |
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10.1007/s00268-014-2770-1 doi (DE-627)SPR003449637 (SPR)s00268-014-2770-1-e DE-627 ger DE-627 rakwb eng Allaix, Marco E. verfasserin aut Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. Achalasia (dpeaa)DE-He213 Esophageal Manometry (dpeaa)DE-He213 Heller Myotomy (dpeaa)DE-He213 Staple Line Leak (dpeaa)DE-He213 Epiphrenic Diverticulum (dpeaa)DE-He213 Borraez Segura, Bernardo A. aut Herbella, Fernando A. aut Fisichella, Piero M. aut Patti, Marco G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2014), 1 vom: 05. Sept., Seite 203-207 (DE-627)SPR003391159 nnns volume:39 year:2014 number:1 day:05 month:09 pages:203-207 https://dx.doi.org/10.1007/s00268-014-2770-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2014 1 05 09 203-207 |
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10.1007/s00268-014-2770-1 doi (DE-627)SPR003449637 (SPR)s00268-014-2770-1-e DE-627 ger DE-627 rakwb eng Allaix, Marco E. verfasserin aut Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. Achalasia (dpeaa)DE-He213 Esophageal Manometry (dpeaa)DE-He213 Heller Myotomy (dpeaa)DE-He213 Staple Line Leak (dpeaa)DE-He213 Epiphrenic Diverticulum (dpeaa)DE-He213 Borraez Segura, Bernardo A. aut Herbella, Fernando A. aut Fisichella, Piero M. aut Patti, Marco G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2014), 1 vom: 05. Sept., Seite 203-207 (DE-627)SPR003391159 nnns volume:39 year:2014 number:1 day:05 month:09 pages:203-207 https://dx.doi.org/10.1007/s00268-014-2770-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2014 1 05 09 203-207 |
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10.1007/s00268-014-2770-1 doi (DE-627)SPR003449637 (SPR)s00268-014-2770-1-e DE-627 ger DE-627 rakwb eng Allaix, Marco E. verfasserin aut Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. Achalasia (dpeaa)DE-He213 Esophageal Manometry (dpeaa)DE-He213 Heller Myotomy (dpeaa)DE-He213 Staple Line Leak (dpeaa)DE-He213 Epiphrenic Diverticulum (dpeaa)DE-He213 Borraez Segura, Bernardo A. aut Herbella, Fernando A. aut Fisichella, Piero M. aut Patti, Marco G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2014), 1 vom: 05. Sept., Seite 203-207 (DE-627)SPR003391159 nnns volume:39 year:2014 number:1 day:05 month:09 pages:203-207 https://dx.doi.org/10.1007/s00268-014-2770-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2014 1 05 09 203-207 |
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10.1007/s00268-014-2770-1 doi (DE-627)SPR003449637 (SPR)s00268-014-2770-1-e DE-627 ger DE-627 rakwb eng Allaix, Marco E. verfasserin aut Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. Achalasia (dpeaa)DE-He213 Esophageal Manometry (dpeaa)DE-He213 Heller Myotomy (dpeaa)DE-He213 Staple Line Leak (dpeaa)DE-He213 Epiphrenic Diverticulum (dpeaa)DE-He213 Borraez Segura, Bernardo A. aut Herbella, Fernando A. aut Fisichella, Piero M. aut Patti, Marco G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2014), 1 vom: 05. Sept., Seite 203-207 (DE-627)SPR003391159 nnns volume:39 year:2014 number:1 day:05 month:09 pages:203-207 https://dx.doi.org/10.1007/s00268-014-2770-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2014 1 05 09 203-207 |
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Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? Achalasia (dpeaa)DE-He213 Esophageal Manometry (dpeaa)DE-He213 Heller Myotomy (dpeaa)DE-He213 Staple Line Leak (dpeaa)DE-He213 Epiphrenic Diverticulum (dpeaa)DE-He213 |
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misc Achalasia misc Esophageal Manometry misc Heller Myotomy misc Staple Line Leak misc Epiphrenic Diverticulum |
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misc Achalasia misc Esophageal Manometry misc Heller Myotomy misc Staple Line Leak misc Epiphrenic Diverticulum |
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Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? |
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Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? |
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Allaix, Marco E. |
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World Journal of Surgery |
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Allaix, Marco E. Borraez Segura, Bernardo A. Herbella, Fernando A. Fisichella, Piero M. Patti, Marco G. |
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39 |
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Allaix, Marco E. |
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10.1007/s00268-014-2770-1 |
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is resection of an esophageal epiphrenic diverticulum always necessary in the setting of achalasia? |
| title_auth |
Is Resection of an Esophageal Epiphrenic Diverticulum Always Necessary in the Setting of Achalasia? |
| abstract |
Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. © Société Internationale de Chirurgie 2014 |
| abstractGer |
Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. © Société Internationale de Chirurgie 2014 |
| abstract_unstemmed |
Background Esophageal epiphrenic diverticulum (ED) is usually secondary to a primary esophageal motility disorder, such as achalasia. Whereas the recommended surgical treatment includes esophageal myotomy and diverticulectomy, the outcome of patients in whom a myotomy without ED resection is performed is not known. The purpose of this study was to compare the outcome of ED patients who underwent ED resection and myotomy and those of ED patients who had a myotomy only. Methods Retrospective review of a prospective database. Thirteen ED patients had symptom evaluation, barium swallow, endoscopy, and esophageal high-resolution manometry (HRM). All patients underwent laparoscopic myotomy and Dor fundoplication. In six patients, the ED was resected (excised ED group), whereas in seven it was left in place (nonexcised ED group): in three because it was small and in four for technical reasons. Results Preoperatively all patients had dysphagia and 85 % had regurgitation. The mean preoperative Eckardt score was 6.5 ± 2.1 in excised ED group and 6.6 ± 3.3 in nonexcised ED group (p = 0.95). HRM showed type II esophageal achalasia in 85 % of patients. One excised ED group patient had a staple line leak (17 %). At a median follow-up of 2 years, the Eckardt score was 0 in excised ED group and 0.1 in nonexcised ED group (p = 0.56). Conclusions The results of this study showed that patients in whom a myotomy without ED resection was performed had resolution of their symptoms. These findings suggest that in patients with achalasia and ED the underlying motility disorder rather than the ED may be the cause of symptoms. Studies with a larger number of patients and a longer follow-up will determine the validity of this approach. © Société Internationale de Chirurgie 2014 |
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