How is esophageal diverticulum treated?
How is esophageal diverticulum treated?
Cases of esophageal diverticulum that cause minor symptoms can be treated through lifestyle changes, such as eating a bland diet, chewing food thoroughly, and drinking plenty of water after meals.
If symptoms become severe, several types of surgery are available to remove the diverticula, repair the defects and relieve a patient’s symptoms and improve their quality of life.
Treatment of diverticula require:
- An examination of the diverticula;
- Repair of the weakened wall; and
- Relief of obstruction
The type of surgical treatment recommended depends on the size and location of diverticula, and include:
Cricopharyngeal myotomy: Used in the removal of small diverticula, this surgical treatment can be completed using an open or trans oral approach.
Diverticulopexy with cricopharyngeal myotomy: Used to remove larger diverticula, this procedure involves turning the diverticular sac upside down and suspending it by suturing it to the esophageal wall.
Diverticulectomy and cricopharyngeal myotomy: Diverticulectomy for the treatment of Zenker's diverticula has been performed for almost a century. The procedure involves complete excision of the diverticular sac.
Recently, Cleveland Clinic surgeons have improved the outcome of this procedure by adding the Heller myotomy laparoscopic approach to ensure the movement of food through the lower esophageal sphincter.
Endoscopic diverticulotomy (Dohlman procedure): This procedure divides the septum between the cervical esophagus and the diverticular pouch. By dividing the septum, food can freely drain from the pouch to the esophagus. Cleveland Clinic surgeons complete this division by using a Zenker’s diverticuloscope and a minimally invasive stapling technique to treat Zenker’s diverticulum.