Tratamiento con endoscopía flexible del divertículo de Zenker: una técnica efectiva y segura

N. González, M. Viola, Arturo Méndez, Andrés Taullard, M. Gentile, A. Gamba, D. Debenedetti, A. Duarte, César Canessa
{"title":"Tratamiento con endoscopía flexible del divertículo de Zenker: una técnica efectiva y segura","authors":"N. González, M. Viola, Arturo Méndez, Andrés Taullard, M. Gentile, A. Gamba, D. Debenedetti, A. Duarte, César Canessa","doi":"10.31837/cir.urug/3.2.1","DOIUrl":null,"url":null,"abstract":"Background: Treatment of Zenker's diverticulum (DZ) has evolved from open surgery to flexible endoscopy, resulting in lower morbidity and mortality. The endoscopic treatment consists of the cricopharyngealmyotomy using multiple devices. \nAim: The purpose of this study is to show a therapeutic alternative for flexible endoscopy for Zenker's diverticulum, using different cutting instruments. \nMethods: We describe a series of cases of patients diagnosed with Zenker's diverticulum treated by endoscopy, between March 2014 and July 2018. Allprocedures were performed by a single endoscopist. Data from endoscopic records werecollected retrospectively and demographic variables, symptoms, technical aspects, complications and follow-up were analyzed. \nResults: 12 patients were included, 7 (58%) female, mean age 69 years (range: 53-90). All patients had dysphagia for solids and liquids, 2 patients also had respiratory symptoms. The average size of the diverticula was 3.6 cm. The myotomy was performed with LigaSure in 4 patients, with clutch-cutter in 3 and needle knife in 5 cases. In 11 (91.6%) cases, symptom improvement was obtained, 2 (16%) patients presented recurrence of symptoms during a median follow-up of 9 months. One case (8%) required endoscopoicreintervention to obtain relief of dysphagia. Microperforationwas presented in one patient (8%), which resolved with conservative treatment. \nConclusions:Diverticulotomy through flexible endoscopy was effective and safe for the treatment of DZ, so it should be considered in the therapeutic arsenal of this pathology.","PeriodicalId":34734,"journal":{"name":"Cirugia del Uruguay","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cirugia del Uruguay","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31837/cir.urug/3.2.1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Treatment of Zenker's diverticulum (DZ) has evolved from open surgery to flexible endoscopy, resulting in lower morbidity and mortality. The endoscopic treatment consists of the cricopharyngealmyotomy using multiple devices. Aim: The purpose of this study is to show a therapeutic alternative for flexible endoscopy for Zenker's diverticulum, using different cutting instruments. Methods: We describe a series of cases of patients diagnosed with Zenker's diverticulum treated by endoscopy, between March 2014 and July 2018. Allprocedures were performed by a single endoscopist. Data from endoscopic records werecollected retrospectively and demographic variables, symptoms, technical aspects, complications and follow-up were analyzed. Results: 12 patients were included, 7 (58%) female, mean age 69 years (range: 53-90). All patients had dysphagia for solids and liquids, 2 patients also had respiratory symptoms. The average size of the diverticula was 3.6 cm. The myotomy was performed with LigaSure in 4 patients, with clutch-cutter in 3 and needle knife in 5 cases. In 11 (91.6%) cases, symptom improvement was obtained, 2 (16%) patients presented recurrence of symptoms during a median follow-up of 9 months. One case (8%) required endoscopoicreintervention to obtain relief of dysphagia. Microperforationwas presented in one patient (8%), which resolved with conservative treatment. Conclusions:Diverticulotomy through flexible endoscopy was effective and safe for the treatment of DZ, so it should be considered in the therapeutic arsenal of this pathology.
Zenker憩室柔性内窥镜治疗:一种有效和安全的技术
背景:Zenker憩室(DZ)的治疗已经从开放手术发展到柔性内窥镜检查,其发病率和死亡率都较低。内窥镜治疗包括使用多种装置的环咽肌切开术。目的:本研究的目的是展示柔性内窥镜治疗Zenker憩室的替代方案,使用不同的切割工具。方法:我们描述了2014年3月至2018年7月期间经内镜治疗的一系列确诊为Zenker憩室的患者。所有手术均由一名内窥镜医师完成。回顾性收集内镜记录的数据,并分析人口统计学变量、症状、技术方面、并发症和随访情况。结果:纳入12例患者,女性7例(58%),平均年龄69岁(53-90岁)。所有患者均出现固体和液体吞咽困难,2例合并呼吸道症状。憩室平均大小3.6 cm。4例采用LigaSure, 3例采用离合刀,5例采用针刀。11例(91.6%)患者症状得到改善,2例(16%)患者在中位随访9个月期间出现症状复发。1例(8%)需要内镜干预以缓解吞咽困难。1例患者(8%)出现微穿孔,经保守治疗解决。结论:柔性内窥镜下憩室切开术治疗DZ是安全有效的,应作为该病理的治疗手段之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
11
审稿时长
29 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信