The Endoscopic Operation for Hypopharyngeal Diverticula: A Roentgencinematographic Study

Dohlman, G. F.; Mattsson, Ove

doi:10.1001/archotol.1960.03770050004002

Cited by 320 publications

(160 citation statements)

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“…Endoscopic treatment was revived by Dohlman and Mattson 17 , which advocated the procedure under general anesthesia, using a rigid endoscope and section of the septum between the esophagus and diverticulum performed with electrocautery. With this technique, cervical incision was abolished, procedure time and hospital stay shortened, the introduction of the diet abbreviated and the number of complications decreased 6 .…”

Section: Results Results Results Resultsmentioning

confidence: 99%

“…Among the techniques employed, the diverticulopexy proposed by Lerut et al 8 in 1990 was replaced by diverticulectomy associated with the cricopharyngeal muscle myotomy, the left cervicotomy being the standard access, with excellent results, represented by no mortality, low morbidity and satisfactory remission of symptoms [9][10][11][12][13][14][15] . Endoscopic treatment, initially proposed by Mosher in 1917 16 , was revived by Dolhman and Mattsson in 1960 17 , and consisted of the complete section of the septum between the esophagus and the diverticulum, promoting communication between the two structures [18][19][20] . The authors noted that this procedure has advantages over e surgical treatment, such as the absence of skin incision, shorter operative time and hospital stay.…”

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confidence: 99%

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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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Section: Results Results Results Resultsmentioning

confidence: 99%

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confidence: 99%

Divertículo faringoesofagiano: avaliação dos resultados do tratamento

Henry

Lerco

Tagliarini

et al. 2013

Rev. Col. Bras. Cir.

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“…5 The endoscopic technique was popularised by Dohlman using a diathermy knife to divide the common septum. 6 This method has since been further modified to include the use of an operating microscope, 7 CO 2 laser, 7,8 KTP laser 9 and, more recently, an endoscopic stapling device. 10 Our aim was to establish current trends in the management of pharyngeal pouches by UK otolaryngologists.…”

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confidence: 99%

Current management in pharyngeal pouch surgery by UK otorhinolaryngologists

Siddiq¹,

Sood²

2004

Ann R Coll Surg Engl

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Introduction: Many surgical techniques have been described for the treatment of pharyngeal pouches but there is no single treatment of choice. The aim of this study was to determine current practice in pharyngeal pouch surgery by UK otolaryngologists. Methods: A postal questionnaire was sent to all UK-based consultant members of the British Association of Otolaryngologists -Head and Neck Surgeons (BAO-HNS).Results: Endoscopic stapling diverticulotomy is the most commonly performed procedure, performed by 89% of surgeons, followed by excision. Of those consultants that considered there to be a treatment of choice, 83% stated endoscopic stapling as their preference. Practices differ regarding the insertion of nasogastric tubes after endoscopic procedures and the need for postoperative barium studies. The length of in-patient stay tends to be short with 80% of surgeons discharging patients by day 2. Conclusions: Endoscopic stapling diverticulotomy is now the most commonly performed procedure for the management of pharyngeal pouches by UK otolaryngologists and is now considered by many to be the treatment of choice.

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“…The endoscopic treatment of pharyngoesophageal diverticulum also has many supporters and great experience is required to do it, which consists of dividing the septum between the diverticulum and the esophagus under endoscopic control [21,22]. Van Overbbek [22] reports endoscopic treatment results in 545 patients during 30 years, obtaining satisfactory improvement of dysphagia in 91% of them, with very low rates of complications.…”

Section: Discussionmentioning

confidence: 99%

Early and late assessment of the surgical treatment of the pharyngoesophageal diverticulum by mechanical and manual suture

Aquino¹,

Chagas²,

Said³

et al. 2017

Otorhinolaryngol Head Neck Sur

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Rationale: The occurrence of the pharyngoesophageal, or Zenker diverticulum is not frequent in the national scenario, and the technique of the diverticulectomy with cricomyotomy in medium and great dimension diverticula is still the most indicated. Because the resection of the diverticulum requires the suture of the pharynx, dehiscence can occur, thereafter delaying swallowing. Hence, the idea to accomplish this surgical procedure, to compare the manual and mechanical suture in order to evaluate the actual benefit of the mechanical technique. Objectives:The objective of this study is to retrospectively evaluate the results of the pharyngoesophageal diverticulectomy with cricomyotomy using manual and mechanical suture in a series of patients with regard to local and systemic complications.Method: 57 patients with pharyngoesophageal diverticula diagnosed through high digestive endoscopy and pharyngeal esophagram were studied. The applied surgical technique was diverticulectomy with myotomy of the cricopharyngeal muscle, done in 24 patients (42.2%) the mechanical suture (Group A) with the mechanical linear suture device and in 33 (57.8%) a manual closure of the pharynx (Group B). Results:In the postoperative period, one patient of Group A (4.1%) presented fistula caused by dehiscence of the pharyngeal suture, and three of Group B (15.1%) presented the same complication, with a good outcome using a conservative treatment. In the same group, 3 patients (9.0%) presented stenosis of the suture of the pharynx, with good outcome and with endoscopic dilatations, and no patient from Group A presented such complication. Lung infection was present in five patients, being two (8.3%) of Group A and three (9.0%) of Group B, having good outcomes after specific treatment. In the late review, done with 18 patients (75.0%) of Group A and 25 (75.7%) of Group B, the patients declared to be pleased with the surgical procedure, because they were able to regain normal swallowing. Conclusion:The diverticulectomy with myotomy and pharyngeal closure using mechanical suture was proven appropriate, for having restored regular swallowing in most of the patients, and the mechanical closure of the pharynx proved to be more effective in comparison to the manual suture, because it provided a lower index of local post-surgical complications.

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The Endoscopic Operation for Hypopharyngeal Diverticula: A Roentgencinematographic Study

Cited by 320 publications

References 4 publications

Divertículo faringoesofagiano: avaliação dos resultados do tratamento

Divertículo faringoesofagiano: avaliação dos resultados do tratamento

Current management in pharyngeal pouch surgery by UK otorhinolaryngologists

Early and late assessment of the surgical treatment of the pharyngoesophageal diverticulum by mechanical and manual suture

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