Zenker's diverticulum surgery: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 12: | Line 12: | ||
*This may be performed through a fibreoptic endoscope<ref>PMID 15966520 Fiberoptic endoscopic-assisted diverticulotomy: a novel technique for the management of Zenker's diverticulum, Ann Otol Rhinol Laryngol. 2005 May;114(5):347-51</ref>. | *This may be performed through a fibreoptic endoscope<ref>PMID 15966520 Fiberoptic endoscopic-assisted diverticulotomy: a novel technique for the management of Zenker's diverticulum, Ann Otol Rhinol Laryngol. 2005 May;114(5):347-51</ref>. | ||
*Other non-surgical treatment modalities exist, such as endoscopic laser, which recent evidence suggests it less effective than stapling.<ref>PMID 16954989 The Endoscopic Management of Zenker Diverticulum: CO2 Laser versus Endoscopic Stapling, Laryngoscope. 2006 Sep;116(9):1608-11</ref> | *Other non-surgical treatment modalities exist, such as endoscopic laser, which recent evidence suggests it less effective than stapling.<ref>PMID 16954989 The Endoscopic Management of Zenker Diverticulum: CO2 Laser versus Endoscopic Stapling, Laryngoscope. 2006 Sep;116(9):1608-11</ref> | ||
*Various surgeries performed for the ZD are as follows | |||
*Endoscopic diverticulotomy- the two types of endoscopic diverticulotomy are rigid endoscopic diverticulotomy and flexible endoscopic diverticulotomy. | |||
*Endoscopic diverticulotomy | |||
-Four types of procedures are performed using rigid scope | |||
1.Endoscopic Electrocautery<ref name="pmid5396435">{{cite journal |vauthors=Costa RC |title=[Use of proteolytic enzymes, isolated or in combination with antibiotics, in orthopedics and in injuries] |language=Portuguese |journal=Rev Bras Med |volume=26 |issue=11 |pages=696–9 |year=1969 |pmid=5396435 |doi= |url=}}</ref><ref name="pmid12215027">{{cite journal |vauthors=Mirza S, Dutt SN, Minhas SS, Irving RM |title=A retrospective review of pharyngeal pouch surgery in 56 patients |journal=Ann R Coll Surg Engl |volume=84 |issue=4 |pages=247–51 |year=2002 |pmid=12215027 |pmc=2504214 |doi= |url=}}</ref> | |||
*This is suitable for smaller lesions and is performed via an endoscope. | |||
*A double-lipped esophagoscope is used and the wall between the diverticulum and oesophageal wall is exposed. | |||
*The hypopharyngeal bar is divided with diathermy or laser. | |||
*Shorter duration of anaesthesia. | |||
*More rapid resumption of oral intake. | |||
*Shorter hospital stay. | |||
*Quicker recovery. | |||
Complications | |||
*Sub-cutaneous emphysema | |||
*Mediastinitis | |||
*Aspiration from the pouch | |||
2.Endoscopic CO2 Laser Technique<ref name="urlSurgical Treatment of Zenkers Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers">{{cite web |url=https://www.karger.com/Article/FullText/351433#ref48 |title=Surgical Treatment of Zenker's Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers |format= |work= |accessdate=}}</ref><ref name="urlSurgical Treatment of Zenkers Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers">{{cite web |url=https://www.karger.com/Article/FullText/351433#ref55 |title=Surgical Treatment of Zenker's Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers |format= |work= |accessdate=}}</ref><ref name="urlSurgical Treatment of Zenkers Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers">{{cite web |url=https://www.karger.com/Article/FullText/351433#ref50 |title=Surgical Treatment of Zenker's Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers |format= |work= |accessdate=}}</ref><ref name="urlSurgical Treatment of Zenkers Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers">{{cite web |url=https://www.karger.com/Article/FullText/351433#ref56 |title=Surgical Treatment of Zenker's Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers |format= |work= |accessdate=}}</ref> | |||
*The high energy, high focus beam, and less tissue trauma. | |||
*It also provides a better visualization of the diverticular bridge and easier control of the operation. | |||
Compliations | |||
*Mediastinitis | |||
*Sub-cutaneous emphysema | |||
3.Endoscopic Stapling | |||
4.Endoscopic Harmonic Scalpel | |||
- | |||
==References== | ==References== | ||
Revision as of 15:45, 3 November 2017
|
Zenker's diverticulum Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Zenker's diverticulum surgery On the Web |
|
American Roentgen Ray Society Images of Zenker's diverticulum surgery |
|
Risk calculators and risk factors for Zenker's diverticulum surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Surgery is the most definitive therapy for the Zenker's diverticulum (ZD). If small and asymptomatic, no treatment is necessary. Larger, symptomatic cases of Zenker's diverticulum have been traditionally treated by neck surgery to resect the diverticulum and incise the cricopharyngeus muscle. However, in recent times non-surgical endoscopic techniques have gained more importance, and the currently preferred treatment is the endoscopic stapling i.e. closing of the diverticulum via a stapler inserted through a tube in the mouth. This may be performed through a fiberoptic endoscope. Other non-surgical treatment modalities exist, such as endoscopic laser, which recent evidence suggests it less effective than stapling.
Surgery
- If small and asymptomatic, no treatment is necessary.
- Larger, symptomatic cases of Zenker's diverticulum have been traditionally treated by neck surgery to resect the diverticulum and incise the cricopharyngeus muscle.
- However, in recent times non-surgical endoscopic techniques have gained more importance (as they allow for much faster recovery), and the currently preferred treatment is endoscopic stapling[1][2] (i.e. closing of the diverticulum via a stapler inserted through a tube in the mouth).
- This may be performed through a fibreoptic endoscope[3].
- Other non-surgical treatment modalities exist, such as endoscopic laser, which recent evidence suggests it less effective than stapling.[4]
- Various surgeries performed for the ZD are as follows
- Endoscopic diverticulotomy- the two types of endoscopic diverticulotomy are rigid endoscopic diverticulotomy and flexible endoscopic diverticulotomy.
- Endoscopic diverticulotomy
-Four types of procedures are performed using rigid scope 1.Endoscopic Electrocautery[5][6]
- This is suitable for smaller lesions and is performed via an endoscope.
- A double-lipped esophagoscope is used and the wall between the diverticulum and oesophageal wall is exposed.
- The hypopharyngeal bar is divided with diathermy or laser.
- Shorter duration of anaesthesia.
- More rapid resumption of oral intake.
- Shorter hospital stay.
- Quicker recovery.
Complications
- Sub-cutaneous emphysema
- Mediastinitis
- Aspiration from the pouch
2.Endoscopic CO2 Laser Technique[7][7][7][7]
- The high energy, high focus beam, and less tissue trauma.
- It also provides a better visualization of the diverticular bridge and easier control of the operation.
Compliations
- Mediastinitis
- Sub-cutaneous emphysema
3.Endoscopic Stapling 4.Endoscopic Harmonic Scalpel -
References
- ↑ PMID 15453934 Endoscopic stapling of the pharyngeal pouch, J Laryngol Otol. 2004 Aug;118(8):601-6
- ↑ PMID 12782805 Endoscopic staple diverticulostomy for Zenker's diverticulum: a review of literature and experience in 159 consecutive cases, Laryngoscope. 2003 Jun;113(6):957-65
- ↑ PMID 15966520 Fiberoptic endoscopic-assisted diverticulotomy: a novel technique for the management of Zenker's diverticulum, Ann Otol Rhinol Laryngol. 2005 May;114(5):347-51
- ↑ PMID 16954989 The Endoscopic Management of Zenker Diverticulum: CO2 Laser versus Endoscopic Stapling, Laryngoscope. 2006 Sep;116(9):1608-11
- ↑ Costa RC (1969). "[Use of proteolytic enzymes, isolated or in combination with antibiotics, in orthopedics and in injuries]". Rev Bras Med (in Portuguese). 26 (11): 696–9. PMID 5396435.
- ↑ Mirza S, Dutt SN, Minhas SS, Irving RM (2002). "A retrospective review of pharyngeal pouch surgery in 56 patients". Ann R Coll Surg Engl. 84 (4): 247–51. PMC 2504214. PMID 12215027.
- ↑ 7.0 7.1 7.2 7.3 "Surgical Treatment of Zenker's Diverticulum - FullText - Digestive Surgery 2013, Vol. 30, No. 3 - Karger Publishers".