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Hi Kathie... I am glad to hear that.. I just hope when I post the Jama

articles that it benefits someone.!

Carolyn

--- zekenoahme <kgasior2@...> wrote:

> For what it is worth ... Dr. Luketich is my surgeon and he

> really did wonderful for me.

> Kathie in Pittsburgh

>

>

> >

> > Ann Thorac Surg 2005;80:2076-2080

> > © 2005 The Society of Thoracic Surgeons

> >

> > ---------------------------------

> > Original article: General thoracic Minimally Invasive Operation

> for Esophageal Diverticula Hiran C. , MD * , D.

> Luketich, MD, Samphire, MD, Alvelo-, MD, Neil A.

> Christie, MD, Percival O. Buenaventura, MD, Rodney J. Landreneau,

> MD Division of Thoracic and Foregut Surgery, University of

> Pittsburgh Medical Center, Pittsburgh, Pennsylvania Accepted for

> publication June 3, 2005. * Address correspondence to Dr ,

> Cardiothoracic Surgery, Boston Medical Center, 88 East Newton Street,

> B402, Boston, MA 02118 (Email: hiran.fernando@b... ' + u

> + '@' + d + ''//--> ).

> > BACKGROUND: Mid and lower esophageal diverticula are rare

> entities usually managed by open operation. Morbidity can be

> significant with these complex procedures. This study evaluates our

> results of minimally invasive surgery for esophageal diverticula.

> METHODS: Over a 5-year period, 20 patients underwent operation for

> esophageal diverticula. Median age was 70.5 years. There were 16

> epiphrenic and 4 midesophageal diverticula with a median size of 7.5

> cm (range, 2-11 cm). Symptoms included dysphagia (14), regurgitation

> (12), weight loss (8), heartburn (4), aspiration pneumonia (3), chest

> pain (2), and vomiting (2). Dysphagia scores (1 = none, 5 = severe)

> were recorded before and after operation. RESULTS: Surgical

> approaches were laparoscopy (10), video-assisted thoracic surgery

> (VATS) (7), laparoscopic/VATS (2), and laparoscopic/thoracotomy (1).

> The most common operation performed was a diverticulectomy, myotomy,

> and partial fundoplication (12). Complications occurred in 9 (45%)

> > patients and included 4 (20%) esophageal leaks. Three leak

> patients had successful outcomes; the fourth patient died 61 days

> after operation. Median hospital stay was 5.0 (1–61) days. Detailed

> follow-up was available in 18 patients at a median of 15 (1–70)

> months. Dysphagia scores improved significantly (p < 0.001) from 2.3

> to 1.3 postoperatively. Symptomatic improvement was excellent in 13

> (72%), good in 2 (11%), fair in 1 (6%), and poor in 2 (11%)

> patients. CONCLUSIONS: Minimally invasive operations for esophageal

> diverticula are feasible but also challenging. The potential for

> morbidity is significant. Patients should be selected and evaluated

> carefully before undertaking repair. Open surgery should remain the

> standard except in centers experienced with minimally invasive

> esophageal surgery.

> >

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