[Surgical treatment of pulsion diverticula of the esophagus]

A retrospective study of 53 patients, operated upon for esophageal pulsion diverticula, is used to compare results with those in the literature in an attempt to improve operative indications with the hope of reducing the number of only fair short and long term results. Findings showed that results were rated as good in 81% of the 35 patients with pharyngo-esophageal diverticula and 65% of the 18 with epiphrenic diverticula. Indications for operation for pharyngo-esophageal diverticula can be based on clinical and radiological signs. Cricopharyngeal manometry indicates that myotomy is a logical procedure but results show that it is not necessary for choice of indications for surgery. Our preference is for a diverticulectomy, with or without associated myotomy, of debatable value. In contrast, for epiphrenic diverticula, functional esophageal explorations provide greater precision of the type of dyskinesia and allow better adaptation of surgery to type of dyskinesia associated with diverticulum.