Feeley M A, Righi P D, Weisberger E C, Hamaker R C, Spahn T J, Radpour S, Wynne M K
Department of Otolaryngology--Head and Neck Surgery, Indiana University Medical Center, Indianapolis, USA.
Laryngoscope. 1999 Jun;109(6):858-61. doi: 10.1097/00005537-199906000-00003.
To identify risk factors for postoperative complications in patients undergoing diverticulectomy and cricopharyngeal (CP) myotomy for Zenker's diverticulum.
Retrospective.
A chart review was conducted of all patients with a Zenker's diverticulum who were treated with diverticulectomy and cricopharyngeal myotomy at three tertiary care centers in central Indiana between 1988 and 1998.
Of the 24 patients identified, 9 developed postoperative complications (2 medical and 7 surgical). Statistical analysis of multiple potential risk factors revealed that only diverticulum size greater than 10 cm2 at surgery placed the patient at increased risk for postoperative surgical complications. To our knowledge, this is the first report that has specifically addressed diverticulum size as an independent risk factor for postoperative surgical complications following diverticulectomy and CP myotomy.
Given our findings, we recommend considering diverticulopexy rather than diverticulectomy in a patient with a Zenker's diverticulum greater than 10 cm2 in size if a cervical approach is the selected treatment.
确定接受憩室切除术及环咽肌(CP)肌切开术治疗Zenker憩室患者术后并发症的危险因素。
回顾性研究。
对1988年至1998年期间在印第安纳州中部三个三级医疗中心接受憩室切除术及环咽肌肌切开术治疗的所有Zenker憩室患者的病历进行回顾。
在确定的24例患者中,9例出现术后并发症(2例内科并发症和7例外科并发症)。对多种潜在危险因素的统计学分析显示,仅手术时憩室大小大于10 cm²会使患者术后发生外科并发症的风险增加。据我们所知,这是第一份专门探讨憩室大小作为憩室切除术及CP肌切开术后外科并发症独立危险因素的报告。
基于我们的研究结果,我们建议,如果选择经颈部入路治疗,对于大小大于10 cm²的Zenker憩室患者,考虑行憩室固定术而非憩室切除术。