Selective Use of Myotomy for Treatment of Epiphrenic Diverticula: Manometric and Clinical Analysis

John M. Streitz, Michael E. Glick, F. Henry Ellis

Research output: Contribution to journalArticlepeer-review

75 Scopus citations

Abstract

The pathogenesis and treatment of epiphrenic diverticula remain controversial subjects. Most surgeons recommend esophagomyotomy in association with diverticulectomy in every patient. We believe that selective use of myotomy, based on manometry, should be used. From 1960 to 1990, 16 patients underwent surgical treatment for epiphrenic diverticulum at the Lahey Clinic Medical Center, Burlington, Mass. Six patients, three of whom underwent diverticulectomy alone and three who underwent an associated long myotomy, had the lower esophageal sphincter left intact; long-term results were good in all patients. The remaining 10 patients underwent myotomy of the lower esophageal sphincter. Reflux esophagitis developed in two of these patients who had a normal lower esophageal sphincter. Clinical results support the selective use of esophagomyotomy applied to areas of demonstrated dysmotility. A normal lower esophageal sphincter should be left intact to prevent reflux complications.

Original languageEnglish (US)
Pages (from-to)585-588
Number of pages4
JournalArchives of Surgery
Volume127
Issue number5
DOIs
StatePublished - May 1992

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