Evaluation of endoscopic harmonic diverticulostomy.
Laryngoscope
; 122(6): 1297-300, 2012 Jun.
Article
em En
| MEDLINE
| ID: mdl-22447228
ABSTRACT
OBJECTIVES/HYPOTHESIS:
The purpose of this study is to review a consecutive series of patients with Zenker's diverticulum who were treated with endoscopic diverticulostomy using either the endoscopic stapler (ENDO GIA 30 Autosuture; Covidien, Dublin, Ireland) or Harmonic Ultrasonic Surgical Instrumentation (Ethicon Endo-Surgery, Cincinnati, OH) to evaluate the safety and optimal application of Harmonic technology to the treatment of patients with Zenker's diverticulum. STUDYDESIGN:
This is a retrospective review at a tertiary academic hospital with institutional review board approval.METHODS:
All patients undergoing endoscopic repair of Zenker's diverticulum between April 1, 2009 and December 1, 2010 at a single institution were studied.RESULTS:
A total of 65 endoscopic diverticulostomies were performed 24 Harmonic assisted, 41 stapler assisted. Average diverticulum size was 3.46 cm. There were two complications with staple-assisted (pharyngeal leak and recurrence) and six complications with Harmonic-assisted diverticulostomies (two pharyngeal leaks, two chest pains, one recurrence, and one subcutaneous emphysema). There was a statistically significant difference in the complication rates between the staple-assisted (4.88%) and Harmonic-assisted (25%) cohorts (P = .04). There were no complications with diverticula <2 cm.CONCLUSIONS:
Endoscopic Harmonic esophagodiverticulostomy has been reported for the treatment of Zenker's diverticula. However, our data demonstrate a significantly higher complication rate with use of the Harmonic technology compared to the staple-assisted method (P = .04). Additional evaluations are warranted to validate these findings and before Harmonic diverticulostomy can be recommended as treatment for the majority of cases.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Terapia por Ultrassom
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Divertículo de Zenker
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Grampeamento Cirúrgico
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Endoscopia
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Evaluation_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article