传统的隔膜切除术或 Z-POEM 治疗禅克氏憩室

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
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引用次数: 0

摘要

曾克氏憩室(Zenker's diverticulum,ZD)又称环咽袋,是位于咽喉食管交界处背侧的搏动性假憩室。ZD 的病理生理学涉及环咽痉挛、不协调、上食道括约肌开放受损和环咽肌结构变化,从而导致吞咽困难、未消化食物反流、异物感、口臭、意外消瘦和呼吸问题等症状。对有症状的 ZD 的治疗通常包括环咽肌切开术。内窥镜技术,尤其是柔性内窥镜隔肌切开术(FES)和Zenker口周内窥镜肌切开术(Z-POEM),因其微创性而成为首选。本综述讨论了 FES 和 Z-POEM 的技术和临床效果,重点关注特定的临床情况,以指导如何选择这些方法。此外,还分析了 FES 技术的可变性、Z-POEM 的有效性以及不同憩室大小对治疗效果的影响,从而提供了当前 ZD 治疗方法的全面概述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traditional septotomy or Z-POEM for Zenker's diverticulum

Zenker's diverticulum (ZD), also known as a cricopharyngeal pouch, is a pulsion pseudodiverticulum located dorsally at the pharyngoesophageal junction. The pathophysiology of ZD involves cricopharyngeal spasm, incoordination, impaired upper esophageal sphincter opening, and structural changes in the cricopharyngeal muscle, leading to symptoms such as dysphagia, regurgitation of undigested food, foreign body sensation, halitosis, unintentional weight loss, and respiratory issues. Treatment for symptomatic ZD typically involves myotomy of the cricopharyngeal muscle. Endoscopic techniques, particularly flexible endoscopy septotomy (FES) and Zenker peroral endoscopic myotomy (Z-POEM), have become preferred options due to their minimally invasive nature. This review discusses the techniques and clinical outcomes of FES and Z-POEM, focusing on specific clinical scenarios to guide the choice between these methods. Additionally, the variability in FES techniques, the effectiveness of Z-POEM, and the impact of different diverticulum sizes on treatment outcomes are analyzed, providing a comprehensive overview of current therapeutic approaches for ZD.

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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
23
审稿时长
69 days
期刊介绍: Each topic-based issue of Best Practice & Research Clinical Gastroenterology will provide a comprehensive review of current clinical practice and thinking within the specialty of gastroenterology.
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