Esophageal diverticula include 3 types, pharyngoesophageal diverticula, middle esophageal diverticula and supradiaphragmatic esophageal diverticula. Clinical symptoms of supradiaphragmatic esophageal diverticula include dysphagia, chest pain, reflux symptoms and associated respiratory symptoms due to aspiration. Supradiaphragmatic diverticula are often associated with abnormal esophageal motility; therefore, patients with supradiaphragmatic esophageal diverticula may also exhibit symptoms of abnormal esophageal motility. Diagnostic tests include barium swallow esophagogram, esophageal endoscopy, and esophageal pressure and pH measurements. Possible complications of supradiaphragmatic diverticula include esophagitis, esophageal cancer, and possible perforation. The treatment is resection of the diverticulum and, in the case of a combination of abnormal esophageal motility diseases such as cardia loss, a longitudinal incision of the esophageal muscle layer can be performed at the same time. Shen Zhenyun, Department of Thoracic and Cardiovascular Surgery, Aviation General Hospital of China Medical University
Recently, a patient with lower esophageal diverticulum recovered successfully after thoracoscopic-assisted esophageal diverticulectomy. The key points of the operation included: freeing the lower esophagus and fully freeing the diverticulum root after applying a traction band; removing the diverticulum with a suture cutter along the esophageal wall with longitudinal closure at the diverticulum root and traction on the distal end of the diverticulum to facilitate complete removal of the diverticulum; intermittently suturing the esophageal muscular layer and embedding the sutured section of the diverticulum; injecting gas into the esophageal lumen to test the esophagus The air was injected into the lumen of the esophagus to test the tightness of the esophagus. The figure below shows the preoperative esophagogram.