PRESENTATION AND SURGICAL-MANAGEMENT OF BRONCHOGENIC AND ESOPHAGEAL DUPLICATION CYSTS IN ADULTS

Objective: Bronchogenic and esophageal duplication cysts are congenita l anomalies of the tracheobronchial tree and foregut that are often as ymptomatic at initial presentation in adults. Surgery is always recomm ended, even for patients with asymptomatic disease, because of the pos sible development of symptoms and complications during the natural cou rse of the disease and because definitive diagnosis can be established only on surgical specimen. Methods: Twenty-seven patients with bronch ogenic and esophageal duplication cysts were treated in our institutio n over the last 2 decades. Ten patients (37%) were asymptomatic at ini tial presentation. Chest pain and dysphagia were the most common compl aints in symptomatic patients affected by bronchogenic and duplication cysts, respectively. Results: A complete excision of the cyst was per formed in 26 cases, whereas one patient with intrapulmonary cyst under went a right upper pulmonary lobectomy. A posterolateral thoracotomy w as performed in 23 patients, and a video-assisted thoracoscopy using a three-port technique was performed in the last 4 patients. No postope rative morbidity was recorded. All patients, except one, were asymptom atic at a median follow-up time of 4 years. Conclusions: Surgery is th e treatment of choice for bronchogenic and esophageal duplication cyst s. Video-assisted thoracoscopy should represent the first-line approac h in these patients.