Management

Management of diverticula is the same as for other motility disorders with the application of a myotomy. This can be done under local or general anesthesia. Incision is made along the left SCM. The cervical esophagus is exposed by retraction of the SCM and carotid laterally and the trachea medially. The diverticulum is then isolated and can be tacked superiorly to the prevertebral fascia, or a diverticulec-tomy can be performed by firing a TA stapler across the diverticulum. The myo-tomy is done by dividing the muscle 2 cm proximal and 4 cm distal onto the esophagus.

Epiphrenic diverticula arise in the distal third of the esophagus. The management of the diverticulum is dependendant on the severity of the associated symptoms and is usually done with a myotomy to prevent suture line disruption of recurrence of the diverticulum.

References

1. In: Sabiston DC and Spencer FC, eds. Surgery of the chest. 6th ed. Philadelphia: W.B. Saunders Company, 1996.

2. Greenfield LJ, Mulholland M, Oldham KT et al. Surgery scientific principals and practice. 2nd ed. Philadelphia: Lippincott-Raven, 1997.

3. Sabiston DC, Lyerly HK. Textbook of surgery. 15 th ed. Philadelphia: W.B.Saunders Co., 1997.

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