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Postoperative Care of Zenker Diverticula: Contemporary Perspective from the Prospective OUtcomes Cricopharyngeaus Hypertonicity (POUCH) Collaborative.
McKeon, Mallory; McCoy, Nicole; Johnson, Christopher; Allen, Jacqui; Altaye, Mekibib; Amin, Milan; Bayan, Semirra; Belafsky, Peter; DeSilva, Brad; Dion, Greg; Ekbom, Dale; Friedman, Aaron; Fritz, Mark; Giliberto, John Paul; Guardiani, Elizabeth; Kasperbauer, Jan; Kim, Brandon; Krekeler, Brittany N; Kuhn, Maggie; Kwak, Paul; Ma, Yue; Madden, Lyndsay L; Matrka, Laura; Mayerhoff, Ross; Piraka, Cyrus; Rosen, Clark A; Tabangin, Meredith; Wahab, Shaun; Wilson, Keith; Wright, Carter; Young, VyVy N; Postma, Gregory; Howell, Rebecca J.
Afiliação
  • McKeon M; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
  • McCoy N; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
  • Johnson C; Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University Health, Augusta, Georgia, U.S.A.
  • Allen J; Department of Surgery, University of Auckland, Auckland, New Zealand.
  • Altaye M; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
  • Amin M; Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, U.S.A.
  • Bayan S; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
  • Belafsky P; Department of Otolaryngology-Head and Neck Surgery, University of California - Davis, Davis, California, U.S.A.
  • DeSilva B; Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A.
  • Dion G; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
  • Ekbom D; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
  • Friedman A; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
  • Fritz M; Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, U.S.A.
  • Giliberto JP; Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.
  • Guardiani E; Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, U.S.A.
  • Kasperbauer J; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
  • Kim B; Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A.
  • Krekeler BN; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
  • Kuhn M; Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
  • Kwak P; Department of Communication Sciences and Disorders, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio, U.S.A.
  • Ma Y; Department of Otolaryngology-Head and Neck Surgery, University of California - Davis, Davis, California, U.S.A.
  • Madden LL; Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, U.S.A.
  • Matrka L; Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A.
  • Mayerhoff R; Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, U.S.A.
  • Piraka C; Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, U.S.A.
  • Rosen CA; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A.
  • Tabangin M; Department of Gastroenterology/Hepatology, Henry Ford Health System, Detroit, Michigan, U.S.A.
  • Wahab S; Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A.
  • Wilson K; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
  • Wright C; Department of Radiology, University of Cincinnati, Cincinnati, Ohio, U.S.A.
  • Young VN; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
  • Postma G; Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, U.S.A.
  • Howell RJ; Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A.
Laryngoscope ; 134(6): 2678-2683, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38146791
ABSTRACT

OBJECTIVES:

The aim of the study was to identify trends in postoperative management of persons undergoing surgery for Zenker diverticula (ZD) by evaluating length of stay (LOS), diet on discharge, and imaging with or without surgical complication.

METHODS:

Prospectively enrolled adult patients with cricopharyngeal muscle dysfunction with diverticula undergoing surgery from August 1, 2017 to February 1, 2023 were included. Data were extracted from a multi-institutional REDCap database, summarizing means, medians, percentages, and frequencies. Fisher's exact or chi squared analyses were utilized, as appropriate, to compare subsets of data. Descriptive analysis assessed differences in clinical course and the relationship to postoperative management.

RESULTS:

There were 298 patients with a mean (standard deviation) age of 71.8 (11.2) years and 60% male. Endoscopic surgery was performed in 79.5% (237/298) of patients versus 20.5% (61/298) open surgery. Sixty patients (20.1%) received postoperative imaging, with four leaks identified. Complications were identified in 9.4% of cases (n = 29 complications in 28 patients), more commonly in open surgery. Most (81.2%) patients were discharged within 23 h. About half of patients (49%) were discharged from the hospital on a pureed/liquid diet; 36% had been advanced to a soft diet. In patients without complications, LOS was significantly longer following open cases (p = 0.002); postoperative diet was not different between open and endoscopic (p = 0.26).

CONCLUSIONS:

Overall, most patients are discharged within 23 h without imaging. However, LOS was affected by surgical approach. Postoperative complications are different in endoscopic versus open surgery. Complications with either approach were associated with prolonged LOS, need for imaging, and diet restriction. LEVEL OF EVIDENCE Level III Laryngoscope, 1342678-2683, 2024.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cuidados Pós-Operatórios / Complicações Pós-Operatórias / Divertículo de Zenker / Tempo de Internação Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cuidados Pós-Operatórios / Complicações Pós-Operatórias / Divertículo de Zenker / Tempo de Internação Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article