RT Book, Section A1 Hunter, John G. A1 Spight, Donn H. A1 Sandone, Corinne A1 Fairman, Jennifer E. SR Print(0) ID 1162529793 T1 Resection of A Mid-Esophageal Diverticulum with Myotomy T2 Atlas of Minimally Invasive Surgical Operations YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9780071449052 LK accesssurgery.mhmedical.com/content.aspx?aid=1162529793 RD 2024/03/29 AB Esophageal diverticula are rare entities. They are commonly categorized by anatomic location and etiology. Epiphrenic diverticula occur in the distal third of the esophagus and develop by increased intraesophageal pressure secondary to a motility disorder. They are considered pulsion diverticula. Midesophageal diverticula have traditionally been considered traction diverticula and are associated with mediastinal inflammation. Recent work would suggest that most midesophageal diverticula are in fact pulsion diverticula and are associated with motility disorders. Patients with minimal symptoms or small diverticula should not be repaired because of postoperative anastomotic leak rates ranging from 6% to 18% and a perioperative morbidity rate of 33% to 45%. Diverticulectomy and myotomy can be recommended in patients who are symptomatic. The repair of large asymptomatic diverticula may warrant repair as well. Symptoms typically include dysphagia, regurgitation, or weight loss. Less often, chest pain, heartburn, aspiration pneumonia, or vomiting have been noted. It is sometimes difficult to determine the contribution of a diverticula versus a primary motility disorder as the cause of a patient’s symptoms.