title: [Surgical treatment of esophageal diverticula : Endoscopic or open approach?]
abstract: Esophageal diverticula are comparatively rare. The majority are Zenker's diverticula but parabronchial and epiphrenic diverticula can also occur. Parabronchial diverticula are of low clinical relevance, whereas Zenker's and epiphrenic diverticula both belong to the group of pulsion diverticula and can become clinically apparent by dysphagia and regurgitation. Approximately 100 years after the first surgical treatment, peroral approaches (e.g. stapler dissection and flexible endoscopic diverticulotomy) have now achieved a certain level of importance. Both approaches are less invasive than the open approach but are evidently more prone to recurrences. Accordingly, traditional open diverticulectomy with cervical myotomy should be recommended to patients with a reasonable life expectancy and an acceptable operative risk. This holds particularly true for Brombart stages I-III of the disease, as complete myotomy cannot be achieved via the peroral access. The classical surgical treatment of epiphrenic diverticula is open or laparoscopic/thoracoscopic diverticulectomy with distal myotomy, mostly combined with an anterior partial fundoplication; however, the leakage rate is high and several alternative options are currently being evaluated.
authors.affiliation: Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, München, Deutschland. hubertus.feussner@tum.de.
authors.forename: H
authors.initials: H
authors.lastname: Feußner
authors.affiliation: Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Hüser
authors.affiliation: Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Wilhelm
authors.affiliation: Institut für Diagnostische und Interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Fingerle
authors.affiliation: Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Jell
authors.affiliation: Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Friess
authors.affiliation: Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Bajbouj
mesh_terms: D003131:Combined Modality Therapy; D004936:Diverticulum, Esophageal / Q000175:diagnosis / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D018662:Fundoplication / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D013906:Thoracoscopy / Q000379:methods*; D016672:Zenker Diverticulum / Q000175:diagnosis / Q000601:surgery
keywords: Complications; Fundoplication; Laparoscopy; Recurrences; Thoracoscopy