Surgical management of posterior pharyngeal pulsion diverticula: Inversion versus one-stage excision

Bowdler, D. A.; Stell, P. M.

doi:10.1002/bjs.1800741110

Cited by 27 publications

(22 citation statements)

References 18 publications

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“…Cervical myotomy combined with diverticulectomy provides excellent results in most series. The high complication rate of Bowdler [12] with this procedure was not confirmed in any of the studies.…”

Section: Discussioncontrasting

confidence: 47%

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Surgical therapy of Zenker's diverticulum: Low risk and high efficiency

et al. 1990

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Surgery for the treatment of Zenker's diverticulum was performed at our institution in a total of 43 patients over 6 1/2 years. Cervical myotomy with diverticulectomy was performed in 32 of the patients and myotomy alone in 11. Mortality totaled 0%, with a reversible lesion of the recurrent nerve occurring in 7%. In 60% of the cases investigated preoperatively (N = 40), motility disorders of the upper esophageal sphincter (UES) could be demonstrated using manometry as well as with cineradiography in 92% of the patients. Follow-up studies in 39 of the cases 25 months (mean) postprocedure indicated 82% of the patients to be symptom-free, with the remaining 18% demonstrating a marked improvement. Postoperative manometry as well as cineradiography carried out in 12 patients revealed the presence of UES motility dyscoordination in 8% and 25%, respectively. There were, however, no signs of recurrence of the diverticulum. The high number of patients in our study group demonstrating motility disorders of the UES emphasizes the need for cervical myotomy as part of the surgical therapy for Zenker's diverticulum.

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Section: Discussioncontrasting

confidence: 47%

“…Zenker's diverticulum has proven itself to be a disease of the elderly whose proportions increase over the years [1,12,13].…”

Section: Discussionmentioning

confidence: 99%

Surgical therapy of Zenker's diverticulum: Low risk and high efficiency

et al. 1990

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“…As another alternative approach, diverticular inversion itself has not drawn much attention, even though it was shown in some earlier studies to be effective and to have fewer complications than excision [112,113]. Since 1990, there have been very few studies reporting diverticular inversion.…”

Section: How To Deal With Diverticulummentioning

confidence: 99%

Surgical Treatment of Zenker's Diverticulum

Yao¹,

Zhao²,

Hu³

et al. 2013

Dig Surg

154

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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“…Although two stage operations have been described, a single procedure is preferred [30]. Diverticulectomy involves excision of the diverticula.…”

Section: Treatmentmentioning

confidence: 99%

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

Sonbare

2013

Indian J Surg

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Oesophageal diverticulum is divided into two types based on the aetiology: the pulsion and the traction diverticula. Pulsion diverticulum occurs due to increased intraluminal pressure. This can be of three types based on the location along the oesophagus: the Zenker's diverticulum (ZD), the midoesophageal diverticulum (MD) and the epiphrenic diverticulum (ED). A PubMed search was conducted for the words 'pulsion', 'diverticulum' and 'oesophagus' for all studies published from January 1980 to March 2013 in the English language. A total of 31 studies were identified, and out of which, five were not included in the review. The pulsion diverticulum of the oesophagus is an uncommon disorder. Its aetiology is related to the motility disorders of the oesophagus. Patients usually present with chest-related symptoms or oesophageal symptoms, which are related to the underlying motility disorder. Evaluation includes barium studies, gastrointestinal endoscopy, CT scan and oesophageal manometry. Surgery is the treatment of choice for symptomatic and large diverticula, although the outcome in asymptomatic patients is unknown. The surgical options include diverticulectomy or diverticulopexy with an adequate myotomy. Most patients with ZD are now treated by using endoscopic techniques, although no randomised trial has shown its superiority over the open technique. Minimally invasive surgery has also been used for patients with MD and ED. Although isolated case series has shown good improvement in symptoms and reduction in mortality with minimally invasive techniques in patients with ED, its role in thoracic oesophageal diverticulum is debated.

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Surgical management of posterior pharyngeal pulsion diverticula: Inversion versus one-stage excision

Cited by 27 publications

References 18 publications

Surgical therapy of Zenker's diverticulum: Low risk and high efficiency

Surgical therapy of Zenker's diverticulum: Low risk and high efficiency

Surgical Treatment of Zenker's Diverticulum

Pulsion Diverticulum of the Oesophagus: More than just an Out Pouch

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