Xiao Jerry, Gray Katherine D, Chihara Ray, Chan Edward Y, Kim Min P
Division of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, Houston, Texas.
Department of Surgery and Cardiothoracic Surgery, Weill Cornell Medical College, Houston Methodist Hospital, Houston, Texas.
Ann Thorac Surg Short Rep. 2023 May 4;1(3):501-504. doi: 10.1016/j.atssr.2023.04.008. eCollection 2023 Sep.
Epiphrenic diverticulum develops when elevated esophageal intraluminal pressure causes herniation of the mucosa and submucosa through an area of weakness in the muscularis layer. Treatment must address both the diverticulum and the underlying esophageal dysmotility. The endoluminal functional lumen imaging probe allows measurement of the lower esophageal sphincter pressures to achieve the ideal lower esophageal sphincter distensibility that prevents postoperative gastroesophageal reflux disease as well as diverticulum recurrence. We present the case of a 60-year-old woman with an epiphrenic diverticulum who underwent robot-assisted laparoscopic diverticulectomy with Heller myotomy and Dor fundoplication. The endoluminal functional lumen imaging probe was used for intraoperative monitoring.
膈上憩室是由于食管腔内压力升高导致黏膜和黏膜下层通过肌层的薄弱区域疝出而形成的。治疗必须同时针对憩室和潜在的食管动力障碍。腔内功能性管腔成像探头可测量食管下括约肌压力，以达到理想的食管下括约肌扩张度，从而预防术后胃食管反流病以及憩室复发。我们报告一例60岁患有膈上憩室的女性患者，她接受了机器人辅助腹腔镜憩室切除术、Heller肌切开术和Dor胃底折叠术。术中使用了腔内功能性管腔成像探头进行监测。
