Staple-assisted endoscopic management of Zenker’s diverticula: a role in the geriatric population

Khetani, Justin D.; Janjua, Arif; Fenton, Ronald S.

doi:10.1007/s12070-009-0066-9

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…(15) Patients in the study who experienced postprocedural complications required significantly more statistically significant hospitalization. similar data reported by other authors (16).…”

Section: Discussionsupporting

confidence: 93%

Zenker Diverticulum Treatment: Endoscopic or Surgical?

Ciuc¹,

Bîrlă²,

Panaitescu³

et al. 2018

chr

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RezumatIntroducere: Diverticulul Zenker constituie o patologie rară, selecţia pacienţilor pentru tratamente invazive este discutabilă, precum şi metoda terapeutică aplicată. Scopul studiului este de a evalua principalele metode de tratament-chirurgical clasic si endoscopic, în această patologie şi de a corela aspectele fiziopatologice cu consecinţele clinice. Material şi metodă: Am inclus în lotul de studiu 36 pacienţi cu diverticuli cervicali Zenker trataţi în perioada 2010/2017 în două clinici universitare: 7 pacienţi prin abord chirurgical clasic la Clinica de Chirurgie Generală şi Esofagiană a Spitalului Clinic Sfânta Maria Bucureşti şi 29 de pacienţi cu abord endoscopic la Departamentul de Endoscopie Digestivă de Diagnostic şi Intervenţională din cadrul Institutului Regional de Hepatologie şi Gastroenterologie Prof. Dr. Octavian Fodor, Cluj-Napoca. Vârsta pacienţilor a fost cuprinsă între 42 şi 84 ani şi în decada a 7a -15 pacienţi. Rezultate: Miotomia cricofaringiană s-a efectuat la toţi pacienţii. Diverticulectomia s-a practicat la 7 pacienţi, cei trataţi chirurgical. Durata de spitalizare medie a fost de 4 zile. Complicaţii intraprocedurale au prezentat 3 pacienţi trataţi endoscopic şi au constat în apariţia hemoragiei laminare. La 2 pacienţi s-a practicat hemostază endoscopică cu clipuri şi pensă caldă iar la un pacient s-a efectuat hemostază endoscopică cu clipuri. Complicaţiile postprocedurale au fost: dureri locale, leucocitoză, melenă, febră,

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“…(15) Patients in the study who experienced postprocedural complications required significantly more statistically significant hospitalization. similar data reported by other authors (16).…”

Section: Discussionsupporting

confidence: 93%

Zenker Diverticulum Treatment: Endoscopic or Surgical?

Ciuc¹,

Bîrlă²,

Panaitescu³

et al. 2018

chr

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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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Suture of the mucosa after the endoscopic LASER mucomyotomy of Zenker’s diverticulum

Minovi

Dost

2014

Eur Arch Otorhinolaryngol

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The treatment of choice of Zenker's diverticulum is the rigid endoscopic mucomyotomy. At our ENT department, we usually perform an endoscopic mucosal suture after the myotomy. We diagnosed 49 patients and treated 39 patients between 2003 and 2013 due to a Zenker's diverticulum. We used the classification of Brombart to determine the size of the diverticulum. Surgery was performed as an endoscopic LASER mucomyotomy with mucosal sutures or as an open approach with diverticulectomy and myotomy. Patients were phoned to ask for their complaints postoperatively. The symptoms were classified using a visual scale from 0 (no complaint) until 10 (same or more complaints than before the surgery). The distribution of the diverticulum's size was: 6 patients Brombart I, 11 patients Brombart II, 14 patients Brombart III and 18 patients Brombart IV. 10 patients did not undergo surgery. With 33 patients, we performed an endoscopic operation and 6 patients underwent an open approach. The scale of postoperative complaints was the following: 20 patients (0/10), 12 patients (1/10 or 2/10), 3 patients (3/10), 1 patient (6/10) and 1 patient (10/10). None of the patients suffered from severe complications such as mediastinitis. In 85% of the cases, an endoscopic approach could be performed. Postoperatively, 94% of the patients did not have any or just mild complaints. The risk of severe complications or recurrence of the diverticulum is low. The mucosal suture might reduce the risk of infections.

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Staple-assisted endoscopic management of Zenker’s diverticula: a role in the geriatric population

Abstract: Endoscopic stapling technique (modifi ed Dohlman procedure) for treatment of hypopharyngeal diverticula (Zenker) has been shown to produce outcomes similar to open techniques but with shorter operating times and shorter hospitalization.

Cited by 4 publications

References 20 publications

Zenker Diverticulum Treatment: Endoscopic or Surgical?

Zenker Diverticulum Treatment: Endoscopic or Surgical?

Surgical Treatment of Zenker's Diverticulum

Suture of the mucosa after the endoscopic LASER mucomyotomy of Zenker’s diverticulum

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