We present the case of a 65-year-old woman with al lO-year history of dysphagia, regurgitation, cough, and lO-kilogram weight loss due to an epiphrenic diverticulum associated with esophageal achalasia treated by laparoscopic approach. A preoperative barium swallow showed a dilated sigmoid esophagus with a 6-cm epiphrenic diverticulum. Upper endoscopy with distal biopsies was negative for cancer, and esophageal manometry confirmed 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 PO intake. She was discharged home 5 days after the operation free of symptoms and tolerating a soft diet. Twelve months postoperatively she is still asymptomatic and has gained 8 kilograms. 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 treat epiphrenic diverticula due to esophageal achalasia.
Laparoscopic approach for a case of esophageal achalasia with epiphrenic diverticulum
FEO, Carlo;ZERBINATI, Antonio;GIACOMETTI, Maurizio;PANSINI, Giancarlo;LIBONI, Alberto
2000
Abstract
We present the case of a 65-year-old woman with al lO-year history of dysphagia, regurgitation, cough, and lO-kilogram weight loss due to an epiphrenic diverticulum associated with esophageal achalasia treated by laparoscopic approach. A preoperative barium swallow showed a dilated sigmoid esophagus with a 6-cm epiphrenic diverticulum. Upper endoscopy with distal biopsies was negative for cancer, and esophageal manometry confirmed 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 PO intake. She was discharged home 5 days after the operation free of symptoms and tolerating a soft diet. Twelve months postoperatively she is still asymptomatic and has gained 8 kilograms. 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 treat epiphrenic diverticula due to esophageal achalasia.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
