Abstract
This paper attempts to discuss the pathogenesis and surgical treatment of patients with esophageal diverticulum. Fourteen patients were treated in our department in a ten year period (1965-1975). Of these fourteen patients with esophageal diverticulum, seven patients (fifty percent) complained of clinical symptoms and the others had no symptoms of esophageal diverticulum. Of the fourteen patients, two patients had cervical diverticulum (Zenker's diverticulum) which was discovered accidentally upon examination of hiatus hernia and gastric cancer. Most of our cases involved diverticulum of the middle or lower esophagus.
Excision of esophageal diverticulum was performed only in the seven patients who complained of symptoms of diverticulum of the esophagus. For the patients without clinical symptoms, surgery was not carried out. In the excision of esophageal diverticulum, we have continued to use the “open method” without using crushing instruments (clamps) in order to avoid the so-called two main pitfalls, which are inadequate removal of the sac and the danger of narrowing at the point of excision. The closure of the defect of the esophageal wall must be performed by a two layer method, namely mucosa-tomucosa and muscularis-to-muscularis suture. The mucosal suture is placed, using the method of Sweet's technique, in which the knot lies within the esophageal lumen when tied.
It is the author's opinion that although many techniques have been used for the excision of diverticulum of the esophagus, the “open method” may be the most effective to obtain satisfactory results in the excision of esophageal diverticulum.
