title: Laparoscopic approach for esophageal achalasia with epiphrenic diverticulum.
abstract: We report the case of a 65-year-old woman with a 10-year history of dysphagia, regurgitation, cough, and 10-kg weight loss caused by an epiphrenic diverticulum associated with esophageal achalasia managed with a laparoscopic approach. A preoperative barium swallow showed a dilated sigmoid esophagus with a 6-cm epiphrenic diverticulum. Esophageal manometry confirmed the absence of peristalsis in the esophageal body. We performed a laparoscopic diverticulectomy and a 7-cm distal esophageal myotomy with a Dor fundoplication. The postoperative course was uneventful. On the third postoperative day a barium swallow showed no leak, and the patient started oral intake. She was discharged home 5 days after the operation free of symptoms and tolerating a soft diet. Sixteen months after surgery, she was asymptomatic and had gained 8 kg. A barium swallow showed a normal-size esophagus with regular emptying. We reaffirm the feasibility, safety, and efficacy of the laparoscopic diverticulectomy and distal myotomy with Dor fundoplication to manage epiphrenic diverticula resulting from esophageal achalasia.
authors.affiliation: Department of Surgery, Anesthesiology and Radiology, University of Ferrara, Italy. cvfeo@unife.it
authors.forename: C V
authors.initials: CV
authors.lastname: Feo
authors.forename: P
authors.initials: P
authors.lastname: Zamboni
authors.forename: A
authors.initials: A
authors.lastname: Zerbinati
authors.forename: G C
authors.initials: GC
authors.lastname: Pansini
authors.forename: A
authors.initials: A
authors.lastname: Liboni
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D004936:Diverticulum, Esophageal / Q000209:etiology / Q000601:surgery*; D004931:Esophageal Achalasia / Q000150:complications / Q000601:surgery*; D005260:Female; D018662:Fundoplication; D006801:Humans; D010535:Laparoscopy