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2016, Number 4

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Revista Cubana de Cirugía 2016; 55 (4)

Current treatment of Zenker's diverticulum

Fuentes VE

Language: Spanish
References: 37
Page: 312-324
PDF size: 245.14 Kb.


ABSTRACT

Introduction: Surgery is the treatment of choice in Zenker´s diverticula, but there are different opinions about the access to be used, that is, open or endoscopic.
Objective: To compare the results of the surgical treatment results of Zenker´s diverticulum according to the access employed.
Methods: A literature review was made in PubMed/Medline using the keywords: diverticulum, Zenker, pharyngoesophageal, crycopharyngeal, diverticulectomy, diverticulopexy, diverticulotomy, diverticulostomy in articles published from 2006 to 2016. There were included several studies of more than 40 cases, either comparative or not in English, Spanish, French, Italian and Portuguese languages. The studied variables were surgical indications, recurrence, surgical time, length of time for oral feeding, hospital stay, reoperations, complications, symptoms improvement and mortality.
Results: Randomized studies were not found. Four systematic reviews, one metaanalysis, comparative studies on perioral and transcervical access and others which compare the results of the endoscopic and of the conventional access were all included. Most of them were retrospective. For evaluation of long-term results, those articles with follow-up periods over 12 months were taken.
Conclusions: The open access provides better long-term results, but it has more immediate complications. It is advisable to use it in young patients and when anatomic conditions are unfavorable for the endoscopic treatment. Finally, the endoscopic treatment is an adequate choice for patients with high surgical and anesthetic risk.


REFERENCES

  1. Sonbare DJ. Pulsion diverticulum of the Oesophagus: More than just an Out Pouch. Indian J Surg. 2015;77(1):44-8.

  2. Bizzotto A, Iacopini F, Landi R, Costamagna G.Zenker's diverticulum: exploring treatment options. Acta Otorhinolaryngol Ital. 2013;33(4):219-29.

  3. Lang RA,Spelsberg FW, Winter H, Jauch KW, Hatti TP.Transoral diverticulostomy with a modified Endo-Gia stapler: results after 4 years of experience Surg Endosc. 2008;22(5):1408-14.

  4. Aiolfi A, Scolari F, Saino G, Bonavina L. Current status of minimally invasive endoscopic management for Zenker diverticulum. World J Gastrointest Endosc.2015; 7(2):87-93.

  5. Bonavina L. Surgical management of esophageal diverticula. In: Shackelford's Surgery of the Alimentary Tract. 7th ed. Yeo CJ, editor. Philadelphia: Elsevier, 2013: 362-374.

  6. Tieu BH, Hunter JG. Management of Cricopharyngeal Dysphagia with and without Zender´s Diverticulum. Thorac Surg Clin. 2011;21:511-7.

  7. Shahawy S, Anisiewicz AM, Annino D and Shapiro J. A Comparative Study of Outcomes for Endoscopic diverticulotomy versus External diverticulectomy. Otolaryngol Head Neck Surg. 2014;151(4):646-51.

  8. Feussner H. Zenker's diverticulum: pro operation. Chirurg. 2011;82(6):484,486-9.

  9. Braga de Aquino JL, Salles Chagas JF, Manzano Said MM, Nogueira Pascoal MB, Brandi-Filho LA, Rizzante Pereir DA, et al. Assessment of mechanical and manual suture in the surgical treatment of the pharyngoesophageal diverticulum. ABCD Ar Bras Cir Dig. 2015;28(4):239-42.

  10. Lupinacci RM, Lima AC, Lupinacci RA. Diverticulopexy for the treatment of Zenker's diverticulum. Rev Col Bras Cir. 2013;40(1):72-5.

  11. Helmstaedter V, Engel A, Huttenbrink KB, Guntinas-Lichius O. Carbon dioxide laser endoscopic diverticulotomy for Zenker's diverticulum: results and complications in a consecutive series of 40 patients. ORL J Otorhinolaryngol Relat Spec.2009;71:40-4.

  12. Dzeletovic I, Ekbom DC, Baron TH. Flexible endoscopic and surgical management of Zenker's diverticulum. Expert Rev Gastroenterol Hepatol.2012;6:449-65.

  13. Repici A, Pagano N, Romeo F, Danese S, Arosio M, Rando G, et al. Endoscopic flexible treatment of Zenker's diverticulum: a modification of the needle-knife technique. Endoscopy.2010;42:532-35.

  14. Hondo FY, Maluf-Filho F, Giordano-Nappi JH, Neves CZ, Cecconello I, Sakai P. Endoscopic treatment of Zenker's diverticulum by harmonic scalpel. Gastrointest Endosc.2011;74:666-71.

  15. May JT, Padhya TA, McCaffrey TV. Endoscopic repair of Zenker's diverticulum by harmonic scalpel. Am J Otolaryngol.2011;32:553-6.

  16. Manno M, Manta R, Caruso A, Bertani H, Mirante VG, Osja E, et al. Alternative endoscopic treatment of Zenker's diverticulum: a case series (with video). Gastrointest Endosc.2014;79:168-70.

  17. Cassivi SD, Nichols FC, Deschams C. Esophageal diverticula. En: Shields ThW, LoCicero J, Reed CE, Feins RH (eds). General Thoracic Surgery. 7th ed Chap 156 London Lippincot Williams & Wilkins. 2009:1962-70.

  18. Herbella FA, Patti MG. Modern pathophysiology and treatment of esophageal diverticula. Langenbecks Arch Surg. 2012;397(1):29-35.

  19. Constantin A, Mates IN, Pedrescu D, Hoara P, Achin FI, Constantinoiu S,et al. Principles of surgical treatment of Zenker diverticulum. J Med and Life. 2012;5(1):92-7.

  20. Coughlan CA, Verma SP.The Utility of Recurrent Laryngeal Nerve Monitoring During Open Pharyngeal Diverticula Procedures. Ann Otol Rhinol Laryngol. 2016;125(8):648-51.

  21. Herbella FA, Dubecz A, Patti MG. Esophageal diverticula and cancer. Dis Esophagus. 2012;25(2):153-8.

  22. Bonavina L, Aiolfi A, Scolari F, Bona D, Lovece A, Asti E. Longterm outcome and quality of life after transoral stapling for Zenker diverticulum. World J Gastroenterol. 2015;21:1167-72.

  23. Leibowitz JM, Fundakowski CE, Abouyared. Surgical techniques for Zenker's diverticulum: a comparative analysis. Otolaryngol Head Neck Surg. 2014;151(1):52-58.

  24. Oestreicher-Kedem Y, Wasserzug O, Sagi B, Carmel NN, Zikk D. Revision endoscopic stapler Zenker's diverticulotomy. Surg. Endosc. 2016;30(5):2022-5.

  25. Brace M, Taylor SM, Trites JR, Bethune D, Attia E, Hart RD. Endoscopic stapling versus external transcervical approach for the treatment of Zenker diverticulum. J Otolaryngol Head Neck Surg. 2010;39(1):102-6.

  26. Yuan Y, Zhao YF, Hu Y, Chen LQ. Surgical treatment of Zenker's diverticulum. Dig Surg. 2013;30(3):207-18.

  27. Whited C, Lee WT, Scher R. Evaluation of endoscopic harmonic diverticulostomy. Laryngoscope. 2012;122(6):1297-300.

  28. Scher RL. Zenker Duiverticulum and Clinical Controversies in Otolarygology. Which surgical Approach is Superior. JAMA Otolaryngology-Head & Neck Surgery. 2016;142(4):403-4.

  29. Wilken R, Whited C, Scher RL. Endoscopic staple diverticulostomy for Zenker's diverticulum: review of experience in 337 cases. Ann Otol Rhinol Laryngol. 2015;124(1):21-9.

  30. Silveira ML, Vilhordo DW, Kruel CD. Zenker diverticulum: surgical versus endoscopic treatment. Rev Col Bras Cir. 2011;38(5):343-8.

  31. Verdonck J, Morton RP. Systematic review on treatment of Zenker's diverticulum. Eur Arch Otorhinolaryngol. 2015;272(11):3095-3107.

  32. Kos MP, David EF, Mahieu HF. Endoscopic carbon dioxide laser Zenker's diverticulotomy revisited. Ann Otol Rhinol Laryngol. 2009;118(7):512-8.

  33. Pollei TR, Hinni ML, Hayden RE, Lott DG, Mors MB. Comparison of carbon dioxide laser-assisted versus stapler-assisted endoscopic cricopharyngeal myotomy. Ann Otol Rhinol Laryngol. 2013;122(9):568-74.

  34. Adam SI, Paskhover B, Sasaki CT. Laser versus stapler: outcomes in endoscopic repair of Zenker diverticulum. Laryngoscop. 2012;122(9):1961-6.

  35. Huberty V, El Bacha S, Blero D, Le Moine O, Hassid S, Devière J. Endoscopic treatment for Zenker's diverticulum: long-term results (with video). Gastrointest Endosc.2013;77:701-7.

  36. Johnson ChM, Postma GN. Zenker Divertioculum-Which Surgical Approach is Superior?JAMA Otolaryngology-Head & Neck Surgery. 2016;142(4):401-3.

  37. Seth R, Rajasekaran K, Lee WT, Lorenz RR, Wood BG, Kominsky A, et al. Patient reported outcomes in endoscopic and open transcervical treatment for Zenker's diverticulum. Laryngoscope. 2014;124(1):119-25.




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