418. A TALE OF SIXTEEN ESOPHAGEAL DUPLICATION CYSTS AND ITS MANAGEMENT STRATEGIES

Abstract Background Esophageal duplication cysts are rare entities with a spectrum of clinical presentation. Adults are usually asymptomatic. Surgical management is preferred. We present our experience of management of 16 esophageal duplication cysts. Methods A retrospective cohort analysis of all esophageal duplication cyst patients was performed at our centre from January 2012 to December 2022. Variables collected include patient demographics, operative techniques, morbidity and mortality. Study data was collected using electronic medical records at our centre and follow-up data was taken physically or telephonically. A total of 16 patients of esophageal duplication cyst were identified, out of which 81.25% (13) underwent surgical excision, 6.25% (1) underwent endoscopic aspiration and 12.5% (2) were conserved with expectant management due to co-morbidities. Results Out of 16 patients, 50% (8) were in the lower esophagus, 37.5% (6) were in mid third esophagus and 12.5% (2) were in upper esophagus. The patient population was composed of 75% (12) males and 25% (4) females, and mean age was 47.5 years (27–76). 81.25% (13) patients were symptomatic; common symptoms included chest pain/discomfort, breathlessness, and coughing. The mean size of cyst was 6.4 cm (range: 3-10 cm). 81.25% (13) patients underwent surgery out of which 62.5% (10) underwent VATS/Robotic and 18.75% (3) underwent thoracotomy. The mean hospital stay was 4 days (range: 2–10 days). Two (15.4%) patients developed Clavein-Dindo grade III complication, for which pigtail insertion was done. The most common histopathology found was ciliated columnar epithelium in 61.5% (8) patients. Conclusion Esophageal duplication cysts remain rare in adults and are frequently located in the distal esophagus. Various surgical techniques may successfully be employed in the treatment of this pathology. Minimally invasive procedures have a shorter hospital stay.