Abe Toshihiro, Tangoku Akira, Oka Masaaki
Department of Surgery II, Yamaguchi University School of Medicine, Ube, Japan.
Nihon Geka Gakkai Zasshi. 2003 Sep;104(9):601-5.
Esophageal diverticula are considered to be rare but this has not deterred interest in the condition, either historically or in the present era. Most parabronchial esophageal diverticula are traction diverticula, and resection is thought to be unnecessary. The majority of pharyngoesophageal diverticula and epiphrenic diverticula are pulsion diverticula. It is now well accepted that they correlate with underlying motor disturbance and that surgery is indicated. If there is motor disturbance is preoperative manometry, it is necessary to add myotomy. However, if there is no motor disturbance, the surgical management remains controversial. Recently, minimal access surgery with laparoscopy or thoracoscopy has been successful in the treatment of epiphrenic diverticulum.
食管憩室被认为较为罕见,但无论是在历史上还是当今时代,这都并未阻碍人们对该病症的关注。大多数支气管旁食管憩室是牵引性憩室,一般认为无需进行切除。大多数咽食管憩室和膈上憩室是膨出性憩室。目前人们普遍认为它们与潜在的运动功能障碍相关,且需要进行手术治疗。如果术前测压显示存在运动功能障碍,则有必要加做肌切开术。然而,如果不存在运动功能障碍,手术治疗仍存在争议。近来,采用腹腔镜或胸腔镜的微创手术已成功用于治疗膈上憩室。