title: Minimally invasive surgery combined with peroperative endoscopy for symptomatic middle and lower esophageal diverticula: a single institute's experience.
abstract: BACKGROUND
  Esophageal diverticula are rare, accounting for less than 5% of dysphagia cases. Midesophageal and epiphrenic esophageal diverticula account for about 30% of all esophageal diverticula. Traditionally, thoracotomy or laparotomy were the preferred approaches for surgical therapy. Recently, minimally invasive therapies have been described.
  
  
  METHODS
  We present our experiences of 12 patients with diverticula of the distal two-thirds of the esophagus. Thoracoscopic approach was used to treat midesophageal diverticula and a transhiatal approach was used for the epiphrenic diverticula. Peroperative endoscopy was used in all cases. Underlying causes were also simultaneously dealt with.
  
  
  CONCLUSIONS
  According to our series, epiphrenic diverticula were more common; lateral wall being the most common location. Myotomy and fundoplication were done depending on the underlying disorder. We highlight the importance of peroperative endoscopy to accurately localize and determine extent of diverticulectomy.
  
  
  RESULTS
  Males were more common than females and most patients were elderly. Postoperatively, 2 cases had complications and 1 patient had leak. The length of hospital stay was 3 to 23 days.
  
  
  CONCLUSIONS
  Esophageal diverticula are rare conditions, and minimally invasive surgery is certainly feasible and effective in terms of reduced morbidity.
authors.affiliation: GEM Hospital, Ramanathapuram, Coimbatore, India.
authors.forename: Chinnusamy
authors.initials: C
authors.lastname: Palanivelu
authors.forename: Muthukumaran
authors.initials: M
authors.lastname: Rangarajan
authors.forename: Gobi Shanmugam
authors.initials: GS
authors.lastname: Maheshkumaar
authors.forename: Rangasamy
authors.initials: R
authors.lastname: Senthilkumar
mesh_terms: D000328:Adult; D000368:Aged; D004936:Diverticulum, Esophageal / Q000175:diagnosis* / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D018662:Fundoplication; D006801:Humans; D008297:Male; D008875:Middle Aged; D013906:Thoracoscopy