Therapeutic strategies for epiphrenic diverticula: systematic review

Area of Science:

• Gastroenterology
• Thoracic Surgery
• Digestive Diseases

Background:

• Epiphrenic diverticula are outpouchings in the esophagus, typically asymptomatic.
• Symptomatic presentations like dysphagia, regurgitation, or respiratory issues occur in less than one-third of patients, often necessitating medical attention or surgical intervention.

Purpose of the Study:

• To systematically review and analyze various therapeutic strategies for managing epiphrenic diverticula.
• To compare nonsurgical, traditional surgical, and minimally invasive approaches for symptomatic epiphrenic diverticula.

Main Methods:

• Systematic review of literature on epiphrenic diverticula treatment.
• Analysis of therapeutic options including endoscopic dilatation, left thoracotomy, thoracoscopy, and laparoscopy.

Main Results:

• Nonsurgical endoscopic dilatation is an option for patients unfit for surgery.
• Traditional surgical resection via left thoracotomy remains an approach.
• Minimally invasive techniques like thoracoscopy and laparoscopy are more recent options.

Conclusions:

• Treatment for epiphrenic diverticula should be individualized based on patient condition and symptom severity.
• A thorough evaluation of esophageal morphology and function is crucial for tailoring treatment protocols.
• Management strategies encompass a spectrum from conservative observation to advanced surgical interventions.