Mid-thoracic (middle) esophageal diverticula are characteristically traction diverticula arising as a consequence of mediastinal inflammatory processes. When there is no manometric or radiological evidence of an esophageal motility disorder, the indication for surgical intervention — and the preferred technique — follows a specific clinical logic.
This protocol addresses mid-thoracic traction esophageal diverticula that develop secondary to mediastinal inflammation, in the absence of any esophageal motility disorder or manometric abnormality. Unlike pulsion diverticula, this presentation lacks a functional drive mechanism.
In this setting, traction diverticula rarely reach the threshold for surgical intervention — the specific conditions under which surgery becomes indicated, and how to evaluate them, are defined in the full protocol.
Midesophageal EDs are usually true, traction diverticula, secondary to mediastinal inflammatory processes (classically, traction diverticula are described at this level, but pulsion diverticula can also be found).
Traction diverticula with clear etiopathogenesis (without radiological or especially manometric abnormalities) that suggest or demonstrate the participation of a drive mechanism are rarely indicated for surgery.
Occasionally, if they become retentive or have an endoscopic appearance of diverticulitis, they may require thoracotomy or better thoracoscopy.
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