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    Minimally invasive surgery for epiphrenic diverticula, a type of esophageal outpouching, effectively resolves symptoms in most patients. This approach, often combined with myotomy and anti-reflux procedures, shows low complication rates and long-term symptom relief.

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    Area of Science:

    • Gastroenterology
    • Surgical Innovation
    • Esophageal Diseases

    Background:

    • Epiphrenic diverticula are pulsion-type outpouchings in the distal esophagus.
    • They are frequently associated with esophageal motility disorders, such as achalasia.
    • Symptoms include dysphagia, regurgitation, reflux, and aspiration.

    Purpose of the Study:

    • To evaluate the outcomes of surgical treatment for symptomatic epiphrenic diverticula.
    • To assess the efficacy and safety of minimally invasive surgical techniques for this condition.

    Main Methods:

    • Retrospective review of a prospectively collected surgical outcomes database (August 1997 - August 2018).
    • Analysis of 27 patients who underwent minimally invasive diverticulectomy (laparoscopic or thoracoscopic).
    • Concurrent myotomy and anti-reflux procedures were frequently performed.

    Main Results:

    • Abnormal esophageal motility was diagnosed in 59.2% of patients, most commonly achalasia.
    • All 27 patients underwent successful minimally invasive diverticulectomy without conversion to open surgery.
    • Overall symptom resolution was achieved in 89.9% of patients, with minimal morbidity and no mortality or recurrent diverticula after a mean follow-up of 35.8 months.

    Conclusions:

    • Minimally invasive diverticulectomy is an effective and safe surgical approach for symptomatic epiphrenic diverticula.
    • The procedure offers long-term symptom resolution with a low complication rate.
    • Concurrent myotomy and anti-reflux procedures are often necessary and contribute to successful outcomes.