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17F-194 포럼 발표

Abdominal Versus Thoracic Approach for Epiphrenic Esophageal Diverticulum : Which is Better ?
Shin Kim, Jong Ho Cho, Hong Kwan Kim, Yong Soo Choi,Jhingook Kim, Jae Ill Zo, Young Mog Shim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

Purpose : Thoracic esophageal diverticulum is an uncommon disease and there is no established method of operation for this. The aim of our study was to compare the clinical outcomes of esophageal diverticulectomy between abdominal and thoracic approach.

Methods : From 1996 to 2017, we retrospectively reviewed 37 patients who underwent esophageal diverticulectomy via thoracic or abdominal approach for thoracic esophageal diverticulum at a single-center. Clinical outcomes including postoperative length of stay, the time taken from the operation until oral feeding, leakage rate, and reoperation rate were analyzed between two groups.


Results : Median age was 58 years (range, 23-77). Of these 37 patients, 27 patients (73%) underwent esophageal diverticulectomy via thoracic approach (VATS n= 6; Thoracotomy n=21), and 10 patients (23%) had esophageal diverticulectomy via abdominal approach (Laparoscopy n=7; Laparotomy n=3).
The median duration of hospital days was 9 days (range, 5-211) in thoracic approach and 9 days (range, 5-18) in abdominal approach. There was only one perioperative death in thoracic approach groups. The median time taken from the operation until oral feeding was 5 days (range, 3-299) in thoracic approach and 4.5 days (range, 1-11) in abdominal approach. In thoracic approach group, the leakage rate of esophageal myotomy was 7.41% (n=2), and 5 patients required the reoperation for the management of esophageal leakage or wound infection. However, there was no leakage or reoperation case in abdominal approach group.



Conclusion : Abdominal approach for esophageal diverticulectomy is a feasible and appropriate alternative, providing good access to the distal esophagus and lower mediastinum.


책임저자: Jong Ho Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Shin Kim, E-mail : shinbelief.kim@samsung.com

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