Alexis M Holland, William R Lorenz, Ansley B Ricker, Brittany S Mead, Gregory T Scarola, Paul D Colavita
{"title":"环咽切开术：灵活的内窥镜治疗中小型 Zenker 胃窦憩室的效果。","authors":"Alexis M Holland, William R Lorenz, Ansley B Ricker, Brittany S Mead, Gregory T Scarola, Paul D Colavita","doi":"10.1016/j.amjsurg.2024.115823","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Zenker's diverticulum (ZD) was historically treated with an open transcervical myotomy with diverticulectomy, but endoscopic approaches have gained popularity, though with little recent data. This study aimed to report flexible endoscopic cricopharyngomyotomy (FEC) outcomes, particularly in smaller diverticula.</p><p><strong>Methods: </strong>Patients with ZD treated with FEC at a tertiary center were reviewed. Patients were grouped by diverticulum size: small (sZD)≤1.5 cm; medium (mZD) > 1.5 cm.</p><p><strong>Results: </strong>Of 30 patients, median age, BMI, sex, and comorbidities were similar between sZD (n = 18) and mZD (n = 12). Overall, 80.0 % had the procedure performed with a needle knife. Median number of clips for mucosotomy closure (5.0[5.0,6.0]vs.7.0[5.0,7.0]clips;p = 0.051), operative time (59.5[51.0,75.0]vs.74.5[51.0,93.5]minutes;p = 0.498), length-of-stay (1.0[1.0,1.0]vs.1.0[1.0,1.0]days;p = 0.397), and follow-up (20.8[1.1,33.4]vs.15.6[5.4,50.4]months;p = 0.641) were comparable. There were no postoperative leaks; incomplete myotomy occurred in one sZD, yielding a clinical success rate of 96.7 %.</p><p><strong>Conclusions: </strong>FEC has a high success rate for ZD and an advantage in small diverticula, difficult to treat with stapling or open technique.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115823"},"PeriodicalIF":2.7000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cricopharyngomyotomy: Outcomes of flexible endoscopic management of small and medium sized Zenker's diverticulum.\",\"authors\":\"Alexis M Holland, William R Lorenz, Ansley B Ricker, Brittany S Mead, Gregory T Scarola, Paul D Colavita\",\"doi\":\"10.1016/j.amjsurg.2024.115823\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Zenker's diverticulum (ZD) was historically treated with an open transcervical myotomy with diverticulectomy, but endoscopic approaches have gained popularity, though with little recent data. This study aimed to report flexible endoscopic cricopharyngomyotomy (FEC) outcomes, particularly in smaller diverticula.</p><p><strong>Methods: </strong>Patients with ZD treated with FEC at a tertiary center were reviewed. Patients were grouped by diverticulum size: small (sZD)≤1.5 cm; medium (mZD) > 1.5 cm.</p><p><strong>Results: </strong>Of 30 patients, median age, BMI, sex, and comorbidities were similar between sZD (n = 18) and mZD (n = 12). Overall, 80.0 % had the procedure performed with a needle knife. Median number of clips for mucosotomy closure (5.0[5.0,6.0]vs.7.0[5.0,7.0]clips;p = 0.051), operative time (59.5[51.0,75.0]vs.74.5[51.0,93.5]minutes;p = 0.498), length-of-stay (1.0[1.0,1.0]vs.1.0[1.0,1.0]days;p = 0.397), and follow-up (20.8[1.1,33.4]vs.15.6[5.4,50.4]months;p = 0.641) were comparable. There were no postoperative leaks; incomplete myotomy occurred in one sZD, yielding a clinical success rate of 96.7 %.</p><p><strong>Conclusions: </strong>FEC has a high success rate for ZD and an advantage in small diverticula, difficult to treat with stapling or open technique.</p>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":\" \",\"pages\":\"115823\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjsurg.2024.115823\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjsurg.2024.115823","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Cricopharyngomyotomy: Outcomes of flexible endoscopic management of small and medium sized Zenker's diverticulum.
Background: Zenker's diverticulum (ZD) was historically treated with an open transcervical myotomy with diverticulectomy, but endoscopic approaches have gained popularity, though with little recent data. This study aimed to report flexible endoscopic cricopharyngomyotomy (FEC) outcomes, particularly in smaller diverticula.
Methods: Patients with ZD treated with FEC at a tertiary center were reviewed. Patients were grouped by diverticulum size: small (sZD)≤1.5 cm; medium (mZD) > 1.5 cm.
Results: Of 30 patients, median age, BMI, sex, and comorbidities were similar between sZD (n = 18) and mZD (n = 12). Overall, 80.0 % had the procedure performed with a needle knife. Median number of clips for mucosotomy closure (5.0[5.0,6.0]vs.7.0[5.0,7.0]clips;p = 0.051), operative time (59.5[51.0,75.0]vs.74.5[51.0,93.5]minutes;p = 0.498), length-of-stay (1.0[1.0,1.0]vs.1.0[1.0,1.0]days;p = 0.397), and follow-up (20.8[1.1,33.4]vs.15.6[5.4,50.4]months;p = 0.641) were comparable. There were no postoperative leaks; incomplete myotomy occurred in one sZD, yielding a clinical success rate of 96.7 %.
Conclusions: FEC has a high success rate for ZD and an advantage in small diverticula, difficult to treat with stapling or open technique.
期刊介绍：
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
