Mumbai Doctors successfully treat Epiphrenic diverticula and Achalasia with Laparoscopy

Mumbai: A team of doctors from Zen Multispecialty successfully treated 72 patients with achalasia and 5 patients with diverticulum using a laparoscopic heller procedure known as cardiomyotomy. The study was published in the journal Annals of the royal college of surgeons of England, in 2019.

Epiphrenic esophageal diverticula (ED) are out-pouching of the esophageal lumen, originating in the distal of the esophagus, typically 4-8 cm above the cardia and usually projecting from the right posterior wall. It accounts for <10% of all esophageal diverticula. The prevalence of EED is 0.06-4% based on radiologic and endoscopic findings. The actual incidence of EED is unknown, but, the estimated incidence is about 1:500,000/year.

Esophageal epiphrenic diverticulum is usually secondary to a primary esophageal motility disorder, such as achalasia which is an esophageal motility disorder. Largest series of epiphrenic diverticula are small with up to 3 to 4 patients. Speaking about achalasia, it can affect any part of the digestive tract, including the intestines. In esophageal achalasia, the esophagus does not open to let food pass through, because there is a weakness in the smooth muscle of the lower part of the esophagus, and the lower esophageal sphincter. Dr. Patankar, Dr. Vishakha Karekar, and Dr. Abhay Upasane, who are the consultants attached to Zen Multispecialty, we able to give patients with achalasia, a new lease of life.

Dr. Roy Patankar, Director of Zen Multispecialty, said, “Achalasia is rare, and the cause of it is not known. One can suffer from it any age and may find it difficult to swallow food which is known as dysphagia. One may experience symptoms like food may get stuck in the food pipe, vomiting, weight loss, and cough. And if it is not addressed on time, then it can block one’s food pipe, affect the lungs and one may suffer from pneumonia or food pipe cancer. Previously, achalasia was treated with the help of endoscopic balloon dilation, but would recur within 6 months or a year.”

“In a study carried out by us, for the last 10 years, 72 patients with achalasia were successfully treated, by opting for a laparoscopic heller procedure known as cardiomyotomy. It is a safe, highly effective, and minimally invasive treatment for achalasia. The procedure is done under general anesthesia, wherein the muscle of the food pipe is cut to make it wider and then the muscle is stitched again so that it doesn’t close again, and the sensation that is getting blocked in the food pipe goes away. The advantages of this procedure are that it is a one-time cure and a lasting procedure. After the procedure was performed, the patients were followed up for 2 years and there was a significant improvement in their symptoms. Hence, if you notice symptoms like food getting blocked in the food pipe, or pain while swallowing then you must get it investigated at any age,” concluded Dr. Patankar.

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DOI: 10.1308/rcsann.2019.0007