Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-20T00:48:02.475Z Has data issue: false hasContentIssue false

Pharyngeal pouch: which technique?

Published online by Cambridge University Press:  25 February 2015

D Veivers*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Royal North Shore Hospital, Sydney, and Discipline of Surgery, University of Sydney, New South Wales, Australia
*
Address for correspondence: Dr David Veivers, 30 Cocupara Avenue, Lindfield, NSW 2070, Australia Fax: 61 2 9906 4355, E-mail: [email protected]

Abstract

Background:

Pharyngeal pouches have been recognised as a cause of dysphagia for centuries and have been treated in a variety of ways over that time.

Objective:

This article aimed to analyse the results of surgery by a variety of techniques, as performed by one surgeon.

Method:

A retrospective analysis of a case series was conducted, analysing the variables of patient age, sex, type of surgery, length of hospital stay, leak, recurrence and other complications.

Results:

A total of 121 patients were treated by 135 operations. There were no leaks in the group treated by endoscopic stapling and this group also had a significantly shorter hospital stay. As for recurrence, the lowest rate appeared to be in the group treated by excision of the pouch.

Conclusion:

The techniques used by the author all still seem to have a role in the management of pharyngeal pouch, with the endoscopic stapling approach associated with a low rate of complications and short hospital stay.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Ludlow, A. A case of obstructed deglutition from a preternatural dilation of and bag formed in the pharynx. Med Observ Inq 1769;3:85101Google Scholar
2Zenker, FA, von Ziemssen, H. Dilatations of the esophagus. In: Cyclopaedia of the Practice of Medicine, vol 3. London: Low, Marston, Searle and Rivington, 1878;4668Google Scholar
3Mosher, HP. Web and pouches of the esophagus, their diagnosis and treatment. Surg Gynecol Obstet 1917;25:175–87Google Scholar
4Dohlman, G, Mattsson, O. The endoscopic operation for hypopharyngeal diverticula: a roentgencinematographic study. AMA Arch Otolaryngol 1960;71:744–52CrossRefGoogle ScholarPubMed
5Yeo, JCL, Mackenzie, K. Pharyngeal pouch surgery in north Glasgow: NICE (National Institute for Health and Clinical Excellence) practice or not? J Laryngol Otol 2010;124:533–7CrossRefGoogle ScholarPubMed
6Sharp, D, Newman, J, Magnuson, S. Endoscopic management of Zenker's diverticulum: stapler assisted versus Harmonic Ace. Laryngoscope 2009;119:1906–12CrossRefGoogle ScholarPubMed
7Mortensen, M, Schaberg, M, Genden, E, Woo, P. Transoral resection of short segment Zenker's diverticulum and cricopharyngeal myotomy: an alternative minimally invasive approach. Laryngoscope 2010;120:1722CrossRefGoogle ScholarPubMed
8Weerda, H, Sommer, K, Weerda, N. Endoscopic Surgery of Zenker Diverticulum: A Review of Current Techniques. Tuttlingen: Endo-Press, 2006Google Scholar
9Verhaegen, VJO, Feuth, T, van den Hoogen, FJA, Marres, HAM, Takes, RP. Endoscopic carbon dioxide laser diverticulostomy versus endoscopic staple-assisted diverticulostomy to treat Zenker's diverticulum. Head Neck 2011;33:154–9CrossRefGoogle ScholarPubMed
10Keck, T, Rozsasi, A, Grun, PM. Surgical treatment of hypopharyngeal diverticulum (Zenker's diverticulum). Eur Arch Otorhinolaryngol 2010;267:587–92CrossRefGoogle ScholarPubMed
11Koch, M, Mantsopoulos, K, Velegrakis, S, Iro, H, Zenk, J. Endoscopic laser-assisted diverticulotomy versus open surgical approach in the treatment of Zenker's diverticulum. Laryngoscope 2011;121:2090–4CrossRefGoogle ScholarPubMed
12Gutschow, CA, Hamoir, M, Rombaux, P, Otte, J-B, Goncette, L, Collard, J-M. Management of pharyngoesophageal (Zenker's) diverticulum: which technique? Ann Thorac Surg 2002;74:1677–83CrossRefGoogle ScholarPubMed
13Aly, A, Devitt, PG, Watson, DI, Jamieson, GG, Bessell, JR, Chew, A et al. Endoscopic stapling for pharyngeal pouch: does it make the cut? ANZ J Surg 2004;74:116–21CrossRefGoogle ScholarPubMed
14Visosky, AMB, 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
15Roth, J, Sigston, E, Vallance, N. Endoscopic stapling of pharyngeal pouch: a 10-year review of single versus multiple staple rows. Otolaryngol Head Neck Surg 2009;140:245–9CrossRefGoogle Scholar
16Harris, RP, Weller, M, Porter, M. A follow up audit of pharyngeal pouch surgery using endoscopic stapling. Eur Arch Otorhinolaryngol 2010;267:939–43CrossRefGoogle ScholarPubMed
17Fama, AF, Moore, EJ, Kasperbauer, JL. Harmonic scalpel in the treatment of Zenker's diverticulum. Laryngoscope 2009;119:1265–9CrossRefGoogle ScholarPubMed
18Allen, J, Belafsky, PC. Endoscopic cricopharyngeal myotomy for Zenker's diverticulum using the harmonic scalpel. Ear Nose Throat J 2010;89:216–18CrossRefGoogle ScholarPubMed
19Al Kadi, A-S, Maghrabi, AA, Thomson, D, Gillman, LM, Dhalla, S. Endoscopic treatment of Zenker diverticulum: results of a 7-year experience. J Am Coll Surg 2010;211:239–43CrossRefGoogle Scholar
20Case, DJ, Baron, TH. Flexible endoscopic management of Zenker diverticulum: the Mayo Clinic experience. Mayo Clin Proc 2010;85:719–22CrossRefGoogle ScholarPubMed