Surgical management of esophageal diverticula

The therapy of esophageal diverticula has not yet been defined, even if our knowledge of the functional alterations involved seems to have clarified the pathogenesis of this disease. The objective of this study was to verify the results of surgical therapy carried out following physiopathological criteria. Out of 49 patients seen with esophageal diverticular disease, 18 had cervical diverticula, 9 had epibronchial diverticula, and 22 had epiphrenic diverticula. Thirty‐one patients had an operation performed: 15 had a diverticulectomy only, 13 had a diverticulectomy with subdiverticular myotomy, and 3 had a subdiverticular or Heller myotomy plus a Nissen procedure. There was no operative mortality. Three patients operated on for epiphrenic diverticula developed an intrathoracic esophageal fistula which healed spontaneously. One patient who had a cervical diverticulectomy developed a recurrence. Long‐term results in 29 cases were good. In 2 cases the results could be considered as poor (recurrence, persistent dysphagia). It is concluded that the most effective surgical procedure for esophageal diverticula is to be chosen for each patient on the basis of an accurate preoperative functional study.