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Video-assisted thoracoscopic surgery for large Zenker's diverticulum: report of two cases

Published online by Cambridge University Press:  27 January 2014

A Hay ,
B A Ozdemir ,
Y Soon  and
L Pitkin
A Hay*
Affiliation:
Department of ENT, Royal Surrey County Hospital, Guildford, UK
B A Ozdemir
Affiliation:
Oesophagogastric Unit, Royal Surrey County Hospital, Guildford, UK
Y Soon
Affiliation:
Oesophagogastric Unit, Royal Surrey County Hospital, Guildford, UK
L Pitkin
Affiliation:
Department of ENT, Royal Surrey County Hospital, Guildford, UK
*
Address for correspondence: Mr Ashley Hay, Flat 4, 15 St Philips Rd, Surbiton KT6 4DU, UK Fax: +44 (0)1483 571 122 E-mail: [email protected]
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Abstract

Introduction:

Zenker's diverticulum is a propulsion diverticulum in the pharynx. Current practice for the management of symptomatic pharyngeal pouches includes endoscopic pharyngeal stapling, performed trans-orally, and external approaches via a cervical incision. There is no published recommendation on how to approach diverticula with extension into the mediastinum, which may not be adequately treated with the above methods.

Cases:

We describe two cases in which thoracoscopic mobilisation of Zenker's diverticulum was performed using video-assisted thoracoscopic surgery together with traditional transcervical mobilisation and excision of the pouch. This allowed safe surgical access to the inferior limit of the pouch, and delivery of the sac into the neck incision following division of any inferior adhesions (to the great vessels in one case).

Discussion:

In the first report of this technique, we describe a thorough, safe method of dissecting large diverticula that extend into the mediastinum, which minimises the risk to mediastinal structures.

Keywords

Zenker DiverticulumVideo-Assisted Thoracic SurgeryMediastinumPharynxEndoscopy
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 195 - 198
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Zenker, F, Ziemssen, HV. Diseases of the oesophagus. In: Ziemssen, HV, editor. Manual of Special Pathology and Therapy [in German]. Leipzig: FCW Vogel, 1877;1–87Google Scholar
2Killian, G. The mouth of the esophagus. Laryngoscope. 1907;17:421–8Google Scholar
3National Institute for Health and Clinical Excellence. Endoscopic Stapling of the Pharyngeal Pouch. London: National Institute for Health and Clinical Excellence, 2003Google Scholar
4Weissbrod, P, Merati, A. Open surgery for Zenker's diverticulum. Operative Techniques in Otolaryngology - Head and Neck Surgery 2012;23:137–43CrossRefGoogle Scholar
5Siddiq, MA, Sood, S, Strachan, D. Pharyngeal pouch (Zenker’s diverticulum). Postgrad Med J 2001;77:506–11CrossRefGoogle ScholarPubMed
6Dale, OT, Burgess, CA, Corbridge, RJ. Pharyngeal pouch surgery: a combined open and endoscopic approach. Laryngoscope 2012;122:810–12Google Scholar
7Visosky, AM, Parke, RB, Donovan, DT. Endoscopic management of Zenker's diverticulum: factors predictive of success or failure. Ann Otol Rhinol Laryngol 2008;117:531–7CrossRefGoogle ScholarPubMed
8Tulinsky, L, Dostalik, J. Giant Zenker's diverticulum – case report [in Czech]. Rozhl Chir 2011;90:386–8Google ScholarPubMed
9Oey, IF, Richardson, BD, Waller, DA. Video-assisted thoracoscopic thyroidectomy for obstructive sleep apnoea. Respir Med 2003;97:192–3Google Scholar
10Tsai, VW, Cameron, RB, Wang, MB. Thyroidectomy for substernal goiter via a mediastinoscopic approach. Ear Nose Throat J 2006;85:528–9CrossRefGoogle Scholar