[Surgical treatment of diverticula of the thoracic esophagus].
Pathogeny of thoracic esophageal diverticuli, divided into parabronchial and epiphrenic, appears to have been modified by development of functional esophageal motility measurement. We present 23 patients with epiphrenic diverticuli and 3 with parabronchial diverticuli (15 male and 11 female with a mean age of 61 years). Twenty-four underwent surgery: 4 isolated diverticulectomy, 7 diverticulectomy and associated myotomy, 5 myotomy alone, 3 antireflux procedure alone. Three patients required esophagectomy for carcinoma in a diverticulum, for a huge diverticulum adherent to the inferior pulmonary vein. One patient presenting with perforation of a carcinomatous diverticulum in the pleura was treated with pleurotomy and has died. No fistula has been notified. Long term results had been analysed with a mean follow up of 4 years. Special attention has been reported on development of gastro-esophageal-reflux. The finding of a thoracic diverticulum requires evaluation by barium swallow, fibroscopy and functional test which should indicate the operation required. Long term analysis should include functional manometric evaluation and a pHanalysis as long term results are reduced by the appearance of gastro-esophageal-reflux.
Favre
J P
JP
Service de Chirurgie viscérale, Hôpital général, Dijon.
Baulieux
J
J
Ducerf
C
C
Rat
P
P
Haas
O
O
Sala
J J
JJ
D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D004936:Diverticulum, Esophageal / Q000175:diagnosis / Q000601:surgery*; D004733:Enema; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013909:Thorax
D001466:Barium Sulfate
Traitement chirurgical des diverticules de l'oesophage thoracique.