Surgical treatment of thoracic esophageal diverticula

Introduction
Thoracic esophageal diverticulum (TED) is a rare benign disease associated with motility disorders of the esophagus. Surgical management is usually the definitive treatment, with traditional excision of the diverticulum via thoracotomy and minimally invasive techniques being comparable and associated with a mortality rate of between 0 and 10%.

Aim
To present the results of surgical treatment of patients with thoracic diverticula of the esophagus in a 20-year period

Material and methods
The study presents a retrospective analysis of the results of surgical management of patients with the thoracic esophageal diverticulum. All patients underwent open transthoracic diverticulum resection with myotomy. Patients were evaluated for the degree of dysphagia before and after surgery, associated complications and overall comfort after surgical treatment.

Results
Twenty-six patients due to diverticula of the thoracic part of the esophagus underwent surgical treatment. Resection of the diverticulum with esophagomyotomy was performed in 23 (88.5%) patients, anti-reflux surgery was performed in 7 (26.9%) and in 3 (11.5%) patients with achalasia, the diverticulum was left unresected. Among the patients operated on, 2 (7.7%) patients developed a fistula, and both required mechanical ventilation. In 1 patient the fistula closed spontaneously, and the other patient required esophageal resection and colon reconstruction. Two patients required emergency treatment due to mediastinitis. There was no mortality in the perioperative period of hospital stay.

Conclusions
Treatment of thoracic diverticula is a difficult clinical problem. Postoperative complications pose a direct threat to the patient’s life. Esophageal diverticula is characterized by good long-term functional results.