Endoscopic stapling for pharyngeal pouch: does it make the cut?

Aly, Ahmad; Devitt, Peter G.; Watson, David I.; Jamieson, Glyn G.; Bessell, J. R.; Chew, Andrew; Krishnan, Suren

doi:10.1046/j.1445-2197.2003.02909.x

Cited by 14 publications

(5 citation statements)

References 24 publications

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“…One issue in the assessment of recurrence is the definition. Some authors have found that while a pouch may be present, the symptoms have reduced substantially 13 , 16 . Patients will often report improvement (such that food no longer sticks) and satisfaction with the procedure, but some difficulties with swallowing (e.g.…”

Section: Discussionmentioning

confidence: 99%

Pharyngeal pouch: which technique?

Veivers

2015

J. Laryngol. Otol.

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Section: Discussionmentioning

confidence: 99%

Pharyngeal pouch: which technique?

Veivers

2015

J. Laryngol. Otol.

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“…We identified 6,915 patients from 93 studies evaluating the effect of the surgical treatment for ZD, including 52 studies [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59] (n = 3,336) on endoscopic surgeries, 22 [60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81] (n = 2,204) on open surgeries, and 19 [3,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,…”

Section: Search Resultsmentioning

confidence: 99%

Surgical Treatment of Zenker's Diverticulum

Yao¹,

Zhao²,

Hu³

et al. 2013

Dig Surg

151

152

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Background: Different surgical techniques have been indicated for the management of Zenker's diverticulum (ZD), including diverticulectomy, diverticulopexy, and diverticular inversion, with or without myotomy, and myotomy alone. More recently, minimally invasive techniques (such as the transoral endoscopic approach) have become increasingly reliable for this disorder. We therefore conducted this systematic review in order to gain a profound understanding of the current trend and evidence in surgical management of ZD. Methods: Medline and PubMed were searched to identify studies on surgical intervention of ZD published in English between January 1990 and March 2011. Results: We identified 6,915 patients from 93 studies evaluating the effect of the surgical intervention for ZD. No randomized controlled trials comparing one technique with another were identified. Conclusion: Diverticulectomy with myotomy has become the mainstream treatment option for ZD. In certain selected patients, endoscopic diverticulotomy may offer some advantages over open surgery, such as less trauma and a lower complication rate. It is important to individualize optimal therapy for each patient. More randomized controlled trials with long-term follow-up results are required to draw a valid conclusion on the best surgical intervention modality for ZD.

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“…All patients with a symptomatic pharyngeal pouch who were deemed safe to undergo general anaesthesia were offered a cricopharyngeal myotomy via an endoscopic or transcervical approach. These techniques are described elsewhere [4, 8]. During an open approach, the pharyngeal pouch was either left alone, suspended, or excised.…”

Section: Methodsmentioning

confidence: 99%

“…A pharyngeal pouch frequently affects elderly patients, resulting in dysphagia, aspiration pneumonia, malnutrition, and poor quality‐of‐life [3]. Treatment involves division of the cricopharyngeal muscle, which can be accomplished endoscopically or by open neck surgery [3, 4]. Through a transcervical approach, the pouch can be suspended or excised to minimize accumulation of liquids and solids [3].…”

Section: Introductionmentioning

confidence: 99%

Pharyngeal Pouch Surgery in Octo‐ and Nonagenarians is Safe and Effective: A Multicentre Comparative Cohort Study

et al. 2021

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Background Surgery is the only effective treatment strategy for a symptomatic pharyngeal pouch. However, octoand nonagenarians are often denied referral to a surgeon because of perceived increased risks. Here, we compare the outcomes of pharyngeal pouch surgery in octo-and nonagenarians with patients under 80 years-of-age and determine the factors which predict post-operative complications and improvement in swallowing. Methods Analysis of a prospectively maintained database of patients who underwent pharyngeal pouch surgery across seven hospitals over 15 years. Results In total, 113 patients (C80 years-of-age: 27, \80 years-of-age: 86) underwent endoscopic or open pharyngeal pouch surgery. Despite more comorbidities and a longer hospital stay (median: one extra day), patients C80 years-of-age had comparable operative time, complication profile, intensive care admission, emergency reoperation, and revisional pouch surgery as their younger counterparts. Furthermore, the severity of complications was not significantly different between the two age cohorts. No surgical mortality was recorded. Multivariate analysis demonstrated that diverticulectomy combined with cricopharyngeal myotomy independently predicted higher rates of complications (OR: 4.53, 95% CI: 1.43-14.33, p = 0.010), but also greater symptomatic improvement (OR: 4.36, 95% CI: 1.50-12.67, p = 0.007). Importantly, a greater proportion of octo-and nonagenarians experienced improved swallowing than patients \80 years-of-age (96.3% vs. 74.4%, p = 0.013). Moreover, advanced age was not predictive of post-operative complications on multivariate analysis. Conclusions Pharyngeal pouch surgery in octo-and nonagenarians is safe and effective. Surgical correction in this age group alleviates symptoms and improves quality-of-life for most patients. These patients should not be denied surgery on the basis of advanced age alone.Mohamed Afzal and David S. Liu have contributed equally.

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Endoscopic stapling for pharyngeal pouch: does it make the cut?

Cited by 14 publications

References 24 publications

Pharyngeal pouch: which technique?

Pharyngeal pouch: which technique?

Surgical Treatment of Zenker's Diverticulum

Pharyngeal Pouch Surgery in Octo‐ and Nonagenarians is Safe and Effective: A Multicentre Comparative Cohort Study

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