ABSTRACT
OBJECTIVE: To evaluate the postoperative outcome of patients with pharyngoesophageal diverticulum submitted to surgical and endoscopic treatments. METHODS: We retrospectively analyzed 36 patients with pharyngo-esophageal diverticulum treated at the Hospital of the Medical School of Botucatu - UNESP. Patients were divided into two groups, depending on the treatment: group 1 (n = 24): diverticulectomy associated myotomy through a left cervicotomy; group 2 (n = 12): endoscopic diverticulostomy with linear stapler. RESULTS: Operative mortality was zero in both groups. Early complications: group 1 - two patients developed cervical fistula and two, hoarseness; group 2 - none. Late complications: group 1 - none; group 2: recurrence of dysphagia in four patients (p = .01). Mean follow-up was 33 months for group 1 and 28 months for group 2. CONCLUSION: Both procedures were effective in remission of dysphagia. Surgical treatment showed superiority to endoscopy, with resolution of dysphagia with a single procedure. Endoscopic treatment should be reserved for the elderly and those with comorbidities.
Subject(s)
Zenker Diverticulum/surgery , Adult , Aged , Aged, 80 and over , Digestive System Surgical Procedures/methods , Esophagoscopy , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
OBJETIVO: Avaliar a evolução pós-operatória de pacientes com divertículo faringoesofagiano submetidos aos tratamentos cirúrgico e endoscópico. MÉTODOS: Foram analisados de maneira retrospectiva 36 pacientes com divertículo faringo-esofagiano atendidos no Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP. Os pacientes foram distribuídos em dois grupos, na dependência do tratamento: grupo 1 (n=24) - diverticulectomia associada á miotomia do cricofaríngeo, através de cervicotomia esquerda; grupo 2 (n=12) - diverticulostomia endoscópica usando grampeador linear. RESULTADOS: A mortalidade operatória foi nula em ambos os grupos. Complicações precoces: grupo 1 - dois pacientes desenvolveram fistula cervical e outros dois, rouquidão; grupo 2 - sem complicações. Complicações tardias: grupo 1 - sem complicações: grupo 2: recidiva da disfagia em quatro pacientes (p=0,01). O seguimento médio foi 33 meses para o grupo 1 e 28 meses para o grupo 2. CONCLUSÃO: Os dois procedimentos foram eficazes na remissão da disfagia. O tratamento cirúrgico apresentou superioridade em relação ao endoscópico, com resolução da disfagia com um único procedimento. O tratamento endoscópico deve ser reservado para os mais idosos e portadores de comorbidades.
OBJECTIVE: To evaluate the postoperative outcome of patients with pharyngoesophageal diverticulum submitted to surgical and endoscopic treatments. METHODS: We retrospectively analyzed 36 patients with pharyngo-esophageal diverticulum treated at the Hospital of the Medical School of Botucatu - UNESP. Patients were divided into two groups, depending on the treatment: group 1 (n = 24): diverticulectomy associated myotomy through a left cervicotomy; group 2 (n = 12): endoscopic diverticulostomy with linear stapler. RESULTS: Operative mortality was zero in both groups. Early complications: group 1- two patients developed cervical fistula and two, hoarseness; group 2 - none. Late complications: group 1 - none; group 2: recurrence of dysphagia in four patients (p = .01). Mean follow-up was 33 months for group 1 and 28 months for group 2. CONCLUSION: Both procedures were effective in remission of dysphagia. Surgical treatment showed superiority to endoscopy, with resolution of dysphagia with a single procedure. Endoscopic treatment should be reserved for the elderly and those with comorbidities.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Zenker Diverticulum/surgery , Digestive System Surgical Procedures/methods , Esophagoscopy , Retrospective Studies , Treatment OutcomeABSTRACT
Em cada célula existe uma batalha entre a produção de componentes oxidantes provenientes do metabolismo aeróbico e antioxidantes enzimáticos e não enzimáticos naturais. Entre eles, há os compostos sulfurados. O estresse oxidativo desenvolve um papel chave na produção de processos patológicos crônicos como câncer oral. Em uma revisão não sistemática da literatura disponível nós verificamos que o câncer de esôfago é conhecido por sua marcada variação por regiões geográficas e etnia racial e diferenças dietéticas o que poderia contribuir com algumas destas disparidades. Deficiências nutricionais de frutas frescas, vegetais e fibras dietéticas são comumente referidas associadas com a presença de câncer de esôfago. Alem disso, consumo pesado de bebidas alcoólicas de tabaco, e outros riscos de câncer podem interferir no consumo de vitaminas lipossolúveis e hidrossolúveis e componentes dietéticos com potencial efeito anticancerígeno...
In every cell, there is an ongoing battle between the production of oxidants components from the aerobic metabolism and the antioxidants of enzymatic and nonenzymatic nature. Among the later are the sulfur-containing compounds. The oxidative stress plays a key role in production of chronic pathological processes such as oral cancer. In a non-systematic review of the available literature we found that esophageal cancer is known for its marked variation by geographic regions and race ethnicity and the dietary differences may account for at least some of these disparities. Nutritional deficits in fresh fruits, vegetables and dietary fiber are commonly referred as associated with the presence of esophagus cancer. Moreover heavy consumption of alcoholic beverages and tobacco, the other risk factors for the cancer, can interfere with the consumption of liposoluble and hydrosoluble vitamins and dietary components with potential anti-carcinogenic effects...
