Journal de Chirurgie Viscérale – Vol. – N° 4 – p. – Diverticulopexie pour diverticule de Zenker – EM|consulte. A Zenker’s diverticulum, also pharyngoesophageal diverticulum, also pharyngeal pouch, also hypopharyngeal diverticulum, is a diverticulum of the mucosa of. Keywords: Zenker, esophageal diverticulum, diverticulectomy, .. M. Diverticule pharyngo- oesophagien de zenker a propos de cinq cas.
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Other non-surgical treatment modalities also exist, such as endoscopic laser, which recent evidence suggests is less effective than stapling.
InMosher had introduced the technique that uses a rigid endoscope, with the section of the septum of the diverticulum, which was later improved by Dohlman divertickle and Collard inas the performances of the endoscopes got better.
The septum is cut by using linear endostapler of 35 mm EndoGIAcreating a common cavity, in the same time with the section of Upper esophageal sphincter [ 25 ].
Diverticulopexie pour diverticule de Zenker – EM|consulte
diverticile Using manometry combined with video radiography, Cook et al. Early functional results were favorable in all the cases, with the disappearing of dysphagia. However, in recent times non-surgical endoscopic techniques have gained more importance as they allow for much faster recoveryand the currently preferred treatment is endoscopic stapling   i.
After a long-term evolution, it is known that this complication is diagnosed almost exclusively at the pathologic examination of the diverticular resection specimen.
Sincewhen Ludlow had made the first description of the surgical treatment that was reported by Weeler indifferent therapies for Zenker diverticulum were imagined. Idiopathic achalasia is the most frequent esophageal motility disorder.
In the second operation, it was found that there was an incomplete myotomy, the correction of the myotomy leading to the healing of the leak [ 20 ]. The diagnosis was based on a clinical picture severe dysphagia, regurgitations, weight loss and investigations barium passage, upper endoscopy. Surgical approach was left antero-lateral cervicotomy in all cases, regardless of the position of the diverticulum, due to left postero-lateral topography of the cervical esophagus related to trachea at this level, which makes its identification and isolation easier.
Exceptional, pharyngo-esophageal diverticulum can be a rare complication after the surgery of the cervical spine trauma dislocation, fracturethat uses metal plate for fixation. Nowadays, therapeutic management of Zenker diverticulum implies 2 objectives, each one with specific technical details: Laparoscopic excision of a horseshoe-shaped leiomyoma of the lower esophagus.
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Diverticule de Zenker : technique d’agrafage endoscopique par voie transorale
Results There were 5 men and 6 women, mean age 54 years for men and 60 for women. InHarrison added myotomy in the surgical protocol of Zenker diverticulum [ 1112 ].
During that period, more patients were diagnosed with this pathology, but the surgical indication was carefully established, in conformity with the actual practice guides, diveryicule involve the evaluation of the clinical manifestations determined by the diverticulum, as well as the identification and interception of the pathological mechanisms by the therapeutic gesture. Thoracoscopic esophageal diverticulectomy and myotomy. Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus.
DolhmanMattson The endoscopic operation for hypopharyngeal diverticula. Post-traumatic iatrogenic pharyngoesophageal diverticulum.
Diverticula of the esophagus. We have resected the diverticular pouch, an attitude that we consider good for improving dysphagia and preventing stasis complications and malignant transformation. It is a pseudo diverticulum not involving all layers of the esophageal wall. This video demonstrates a robotic-assisted Heller procedure for treatment of esophageal achalasia. This video demonstrates a laparoscopic enucleation of a leiomyoma of the GE junction.
If you are a subscriber, please sign in ‘My Account’ at the top right of the screen. Open surgery represents the most known approach of this pathology, especially in younger patients, due to long term favorable results communicated. Restoration of digestive continuity was achieved through an intrathoracic esophagogastric anastomosis once the stomach has been tubulized.
Received Oct 20; Accepted Jan The simple approach of the diverticular pouch through diverticulectomy or diverticulopexy is insufficient, the therapeutic protocol imposes the interception of etiologic mechanisms, esophageal myotomy distal to the diverticular opening being indispensable. Personal information regarding our website’s visitors, including their identity, is confidential.
The hypo pharynx is exposed using bivalve Weerda laryngoscope, which is positioned behind the endo-tracheal tube, by using an upper digestive endoscope, so that the two blades enter one in the esophageal lumen and the other in the diverticular pouch, exposing the separating septum.
A year-old woman, with a previous history of a “psychological eating disorder”, was referred to the Emergency Department. There are few cases in the literature with esophageal fistula that did not heal under conservative divergicule, making iterative surgery necessary. The conservation of the diverticular pouch after diverticulopexy was for the first time described by Schmid inand made popular by Belsey and Skinner [ 1314 ]. Ivor-Lewis esophagectomy with the patient in a left lateral position: Regarding the surgical indication, it is not yet well established, some authors state that the presence of the diverticular pouch is already a surgical indication, others establish the indication adapted to the case, according to symptoms, age, associated pathology and the presence of complications, attitude that we agree with.
Principles of surgical treatment of Zenker diverticulum
In both cases, the evolution was diverticle under conservative treatment that included partial opening of the cervical wound and extension of nothing by mouth period NPObut the hospital stay doubled. In other projects Wikimedia Commons. World J Gastrointest Surg.
The aim of the study is the reevaluation of the methods and therapeutic principles in pharyngo-esophageal diverticular disease, starting from the etio pathogeny.