The purpose of this study was to investigate outcomes following minimally invasive surgery for mid to distal thoracic esophageal diverticula. We conducted a retrospective review of patients who underwent surgery for symptomatic thoracic esophageal diverticula. Zenker diverticulum patients were excluded. Demographic information and operative details were recorded. Dysphagia score was defined using the Knyrim scoring system (0=no dysphagia, 1=hard solids, 2=soft solids, 3= liquids, 4=saliva). Follow-up included clinical encounters, barium esophagram in all patients and endoscopy in those who developed post-operative symptoms. From September 2001 through September 2024, there were 91 patients with a median follow-up of 19 months. Seventy-nine patients (86.8%) presented with dysphagia. Achalasia was identified in 27 patients. Surgical approaches included VATS (58.2%), laparoscopy (31.9%) or both (8.8%). Myotomy was performed in 85.7%. There were no perioperative mortalities. The median length of stay was 6 days. Six patients had an esophageal leak post-operatively and 4 patients required intervention. Of the 26 patients with a residual or recurrent diverticulum, only 4 required re-operation. At the first post-operative visit, all patients reported an improvement in their dysphagia scores and 88.6% reported no dysphagia. At a median follow-up of 19 months, 30 patients reported some degree of dysphagia but overall remained significantly improved compared to pre-op (p<0.001). Minimally invasive treatment of symptomatic, mid to lower thoracic esophageal diverticula resulted in significant improvement in dysphagia scores and low morbidity.
Matto et al. (Wed,) studied this question.