Evidence map›Paper›PMID 42850304›Full record

ReviewSurgical endoscopy2026

Current status of minimally invasive surgery for thoracic esophageal diverticula: systematic review and meta-analysis.

Alberto Aiolfi, Giacomo Tamburri, Francesco Cammarata, Filippo Bistagnino, Gianluca Bonitta, Aleksandar Simić, Ognjan Skrobic, Christian Alexander Gutschow, Sebastian F Schoppmann, Shahin Ayazi and 5 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Alberto AiolfiDepartment of General Surgery, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy. alberto.aiolfi86@gmail.com.ORCID http://orcid.org/0000-0002-7764-6075
Giacomo TamburriDepartment of General Surgery, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
Francesco CammarataDepartment of General Surgery, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
Filippo BistagninoDepartment of General Surgery, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
Gianluca BonittaDepartment of General Surgery, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
Aleksandar SimićDepartment of Surgery, School of Medicine University of Belgrade, Hospital for Digestive Surgery, University Clinical Center of Serbia, Belgrade, Serbia.
Ognjan SkrobicDepartment of Surgery, School of Medicine University of Belgrade, Hospital for Digestive Surgery, University Clinical Center of Serbia, Belgrade, Serbia.
Christian Alexander GutschowUpper-GI Unit, Department of Visceral and Transplant Surgery, University Hospital Zurich, Zurich, Switzerland.
Sebastian F SchoppmannSurgical Oncology, Department of Surgery, Upper-GI-Service, Medical University of Vienna, Vienna, Austria.
Shahin AyaziDepartment of Surgery, Drexel University, Philadelphia, PA, USA.
Moustafa ElshafeiDepartment of General and Visceral Surgery, Marien Hospital Mainz, Mainz, Germany.
Calin PopaRegional Institute of Gastroenterology and Hepatology O. Fodor Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Croitorilor 19-21, 400162, Cluj-Napoca, Romania.
Davide BonaDepartment of General Surgery, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
Luigi BonavinaDepartment of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Cosenza, Italy.
European Foregut Society (EFS) Collaborative Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThoracic esophageal diverticula, including epiphrenic and parabronchial types, are rare clinical entities representing about 30% of all esophageal diverticula. Thoracic diverticula of the pulsion type have traditionally been associated with motility disorders and treated by stapled diverticulectomy with or without myotomy/fundoplication in patients experiencing disabling symptoms of dysphagia, regurgitation or pulmonary aspiration. Purpose of this study was to review the existing literature and estimate outcomes of minimally invasive surgery.

methodsSystematic review and meta-analysis. PubMed, MEDLINE, Scopus, Web of Science, Cochrane Central Library, and ClinicalTrials.gov were queried. The search was last updated on April 20, 2026. Outcomes were staple-line leak, overall complications, in-hospital mortality, and symptoms improvement.

resultsTwenty-one observational studies including 390 patients were analyzed. The age of the patients ranged from 23 to 83 years. Dysphagia (86%), regurgitation (73.4%), and respiratory symptoms (31.2%) were common indications for surgery. The size of the diverticula ranged from 2 to 11 cm. Preoperative use of standard or high-resolution esophageal manometry was reported in 18 studies. Achalasia (49.2%) was the most commonly associated motility disorder. Laparoscopic (61.9%), thoracoscopic (30.6%), or combined (6.7%) minimally invasive approaches were described. Adjunctive procedures were esophagomyotomy (87%) and Dor (34.6%) or Toupet (17.7%) fundoplication. The estimated pooled prevalence of staple-line leak was 9.8% (95% CrI 7.1-13.4%; I

conclusionsCurrent evidence reporting outcome for minimally invasive midesophageal and epiphrenic diverticulectomy is limited by study design and treatment heterogeneity. Future well-designed multicenter studies are required to assess the effect of surgical approach and esophageal myotomy on short-term morbidity, symptomatic outcomes, and recurrence rate.

Indexed as

DiverticulectomyEsophageal diverticulaFundoplicationMyotomyStaple-line leak

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.