[Thoracoscopic surgery for benign esophageal disease].

Abstract

Two patients with benign esophageal disease were successfully treated by thoracoscopic surgery. First case was a 66 year old male with esophageal diverticulum, who had complained of progressive dysphasia. The esophagogram showed a giant epiphrenic diverticulum which was 8 cm in diameter. Entire procedure was performed thoracoscopically under general anesthesia, while left side univentilation was applied. A flexible videoelectronic thoracoscope was introduced into thoracic cavity at the 5th intercostal space, and 4 additional trocars were inserted. The pleura over the diverticulum was divided, and the diverticulum was fully dissected and exposed. A multifire endoscopic stapler, an Endo GIA, was applied to resect the diverticulum. For security, uninterrupted suture of muscular layer of the esophagus over the stapled line was performed. Second case was a 60 year old male with esophagobronchial fistura, who had complained of choking during liquid intake for 20 years. The bronchogram showed a communication between a esophageal diverticulum and a right B6 bronchus. The operation was performed thoracoscopically. A thoracoscope was introduced as mentioned above, and the esophagus and the peripheral lung around the fistura was dissected and fully exposed. The diverticulum was divided at its base using an Endo GIA, and the fistura was resected with lung parenchyma using also an Endo GIA. The postoperative courses of the both patients were uneventful. The patients started diet on the 4th and the second postoperative day respectively, and the symptoms had disappeared after surgery.