Tratamento cirúrgico do divertículo de Zenker: diverticulopexia versus diverticulectomia

Aandreollo, Nelson Adami; Lopes, Luiz Roberto; Brandalise, Nelson Ary; Camargo, Marcelo Amade; Coelho-Neto, João de Souza

doi:10.1590/s0102-67202007000400006

Cited by 3 publications

(23 citation statements)

References 16 publications

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“…The Zenker`s diverticulum is a saccular deformity located in the inferoposterior wall of the pharynx mucosa, just above the upper esophageal sphincter, over a region in between the inferior pharyngeal constrictor muscle and the cricopharynx muscle, known as Killian`s triangle, which is the weakest area. When there is excessive pressure within the distal pharynx, its wall herniates through the triangle forming the diverticulum 1,24 .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…It has low frequency responding for 1-3% of all the dysphagia complaints and up to 4% of the patients with esophageal diseases 1,18 . There is insufficient data regarding the actual number of cases in South America, including Brazil 1,18 . It prevails among the sixth and eighth decades of life with the highest incidence around 70 years old due to the aging process of loss of muscular tonus and less resistance of the posterior wall, being therefore rare before the forties, 1,18 .…”

Section: Introductionmentioning

confidence: 99%

“…There is insufficient data regarding the actual number of cases in South America, including Brazil 1,18 . It prevails among the sixth and eighth decades of life with the highest incidence around 70 years old due to the aging process of loss of muscular tonus and less resistance of the posterior wall, being therefore rare before the forties, 1,18 . It affects more males than females with a proportion of 3:1 and occurs more often in the Northern countries of Europe, being uncommon in the Middle East region 1,2,18 .…”

Section: Introductionmentioning

confidence: 99%

“…The diagnosis depends on the ability of history taking and is complemented by contrasted radiographic studies of the pharynx and esophagus as well as upper digestive endoscopy. Some cases require esophageal manometry 1,16 .…”

Section: Introductionmentioning

confidence: 99%

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Avaliação da terapêutica cirúrgica do divertículo faringoesofágico pela sutura mecânica

Aquino¹,

Said²,

Chagas³

et al. 2012

ABCD, arq. bras. cir. dig.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Avaliação da terapêutica cirúrgica do divertículo faringoesofágico pela sutura mecânica

Aquino¹,

Said²,

Chagas³

et al. 2012

ABCD, arq. bras. cir. dig.

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Assessment of Mechanical and Manual Suture in the Surgical Treatment of the Pharyngoesophageal Diverticulum

Aquino

Chagas

Said

et al. 2015

ABCD, arq. bras. cir. dig.

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Background: The occurrence of the pharyngoesophageal, or Zenker diverticulum is not frequent in the national scenario, and the technique of the diverticulectomy with cricomyotomy in medium and great dimension diverticula is still the most indicated. Because the resection of the diverticulum requires the suture of the pharynx, dehiscence can occur, thereafter delaying swallowing. Hence, the idea is to accomplish this surgical procedure, comparing the manual and mechanical suture, in order to evaluate the real benefit of the mechanical technique. Aim: To evaluate the results of the pharyngoesophageal diverticulectomy with cricomyotomy using manual and mechanical suture with regard to local and systemic complications. Method: Fifty-seven patients with pharyngoesophageal diverticula diagnosed through high digestive endoscopy and pharyngeal esophagogram were studied. The applied surgical technique was diverticulectomy with myotomy of the cricopharyngeal muscle, done in 24 patients (42.2%) the mechanical suture (group A) with the mechanical linear suture device and in 33 (57.8%) a manual closure of the pharynx (group B). Results: In the postoperative period, one patient of group A (4.1%) presented fistula caused by dehiscence of the pharyngeal suture, and three of group B (15.1%) presented the same complication, with a good outcome using a conservative treatment. In the same group, three patients (9.0%) presented stenosis of the suture of the pharynx, with good outcome and with endoscopic dilatations, and no patient from group A presented such complication. Lung infection was present in five patients, being two (8.3%) of group A and three (9.0%) on B, having good outcomes after specific treatment. In the late review, done with 43 patients (94.4%) of group A and 22 (88.0%) on B, the patients declared to be pleased with the surgical procedure, because they were able to regain normal swallowing. Conclusion: The diverticulectomy with myotomy and pharyngeal closure using mechanical suture was proven appropriate, for having restored regular swallowing in most of the patients, and the mechanical closure of the pharynx proved to be more effective in comparison to the manual one, because it provided a lower index of local post-surgical complications.

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Tratamento cirúrgico de divertículo de Zenker: relato de caso

Pinheiro

Oliveira

Santos³

et al. 2021

Acervo Saúde

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Objetivo: Relatar o caso de uma paciente com diagnóstico de divertículo faringoesofágico, também conhecido como divertículo de Zenker, submetida a tratamento cirúrgico, abordando a técnica cirúrgica, o desfecho e a evolução da paciente ao longo do acompanhamento. Detalhamento de caso: Paciente de 45 anos, sexo feminino, com quadro de disfagia e odinofagia progressivas, associada a sensação de globus e corpo estranho na garganta, além de refluxo gastroesofágico. Realizados exames de imagem que evidenciaram o divertículo hipofaríngeo de cerca de 3 cm, sendo submetida a cervicotomia esquerda longitudinal e posterior diverticulectomia. Abordamos também a evolução pós cirúrgica da paciente. Considerações finais: O divertículo de Zenker é uma patologia adquirida rara, e por isso, muitos cirurgiões formados não tiveram contato ou não têm experiência com as opções terapêuticas disponíveis (reparo aberto por cervicotomia esquerda e reparo por via endoscópica). Portanto, é importante o estudo teórico de tais técnicas, permitindo um desfecho favorável e sem complicações, na maioria das vezes.

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Tratamento cirúrgico do divertículo de Zenker: diverticulopexia versus diverticulectomia

Cited by 3 publications

References 16 publications

Avaliação da terapêutica cirúrgica do divertículo faringoesofágico pela sutura mecânica

Avaliação da terapêutica cirúrgica do divertículo faringoesofágico pela sutura mecânica

Assessment of Mechanical and Manual Suture in the Surgical Treatment of the Pharyngoesophageal Diverticulum

Tratamento cirúrgico de divertículo de Zenker: relato de caso

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