Endoscopic treatment of Zenker's diverticulum

Hashiba, Kiyoshi; Paula, Aureo Ludovico de; Silva, Jose Guilherme N. da; Cappellanes, Carlos Alberto; Moribe, Daniel; Castillo, Carlos Fernández‐del; Brasil, Horus A.

doi:10.1016/s0016-5107(99)70452-9

Cited by 78 publications

(52 citation statements)

References 19 publications

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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%

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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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Section: Search Resultsmentioning

confidence: 99%

“…Using the needle-knife technique, Hashiba et al [35] performed flexible endoscopic diverticulotomy on 47 patients under sedation. Postoperative bleeding (2%) and subcutaneous emphysema (12.8%) were reported in their study.…”

Section: Flexible Endoscopic Diverticulotomymentioning

confidence: 99%

Surgical Treatment of Zenker's Diverticulum

Yao¹,

Zhao²,

Hu³

et al. 2013

Dig Surg

151

152

View full text Add to dashboard Cite

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“…The pathophysiology of the PED is a matter of controversy, and several mechanisms have been described, all of them related to abnormalities presented by the cricopharyngeal muscle, such as spasm, hypertrophy and fibrosis 23 . Manometric studies have shown that contraction after opening of the upper esophageal sphincter happens prematurely, coinciding with the peak of contraction of the pharynx 14 .…”

Section: Results Results Results Resultsmentioning

confidence: 99%

“…The rigid one requires the patient to assume the position of hyperextension of the neck, not always feasible in the elderly, due to cervical arthritis. Thus, the flexible endoscope has been the most suitable for the procedure 19,23 . In this study, we used the rigid endoscope, with no complication.…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Divertículo faringoesofagiano: avaliação dos resultados do tratamento

Henry

Lerco

Tagliarini

et al. 2013

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTObjective Objective Objective Objective Objective: To evaluate the postoperative outcome of patients with pharyngoesophageal diverticulum submitted to surgical and endoscopic treatments. Methods Methods Methods Methods Methods: We retrospectively analyzed 36 patients with pharyngo-esophageal diverticulum treated at the Hospital of the Medical School of Botucatu -UNESP. Patients were divided into two groups, depending on the treatment: group 1 (n = 24): diverticulectomy associated myotomy through a left cervicotomy; group 2 (n = 12): endoscopic diverticulostomy with linear stapler. Results Results ResultsResults Results: Operative mortality was zero in both groups. Early complications: group 1-two patients developed cervical fistula and two, hoarseness; group 2 -none. Late complications: group 1 -none; group 2: recurrence of dysphagia in four patients (p = .01). Mean follow-up was 33 months for group 1 and 28 months for group 2. Conclusion Conclusion Conclusion Conclusion Conclusion: Both procedures were effective in remission of dysphagia. Surgical treatment showed superiority to endoscopy, with resolution of dysphagia with a single procedure. Endoscopic treatment should be reserved for the elderly and those with comorbidities.

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“…The myotomy can be accomplished by using electrocautery. The incision is made beginning from the superior part of the cricopharyngeal bar using a needle knife [14,16,[98][99][100][101]. Alternatively, argon plasma coagulation (APC) can be used for the incision [18,97].…”

Section: Cmementioning

confidence: 99%