Pathophysiologic and therapeutic aspects of esophageal diverticula [Aspetti fisiopatologici e terapeutici dei diverticoli dell'esofago]

The authors reviewed 23 surgical cases of symptomatic oesophageal diverticula. In Zenker's diverticula (7 cases) the surgical treatment consisted of extramucosal cricopharyngeal miotomy and diverticulectomy (6 patients) or diverticulum suspension (1 patient). The operations in epifrenic (15 patients) and mid-thoracic (1 patient) diverticula were as follow: diverticulectomy, longitudinal extramucosal miotomy and antireflux surgery (11 cases); miotomy and antireflux surgery (4 cases); miotomy alone (1 patient). There was no operative mortality. Postoperative complications occurred in 3 patients (13%). 15 patients were followed for an average time of 60 months. None of them developed postoperative disfagia. Pathogenesis, diagnostic methods and surgical options are discussed.