Leporrier J, Salamé E, Gignoux M, Ségol P
Service de chirurgie générale et digestive, CHU Côte-de-Nacre, 14033 Caen, France.
Ann Chir. 2001 Feb;126(1):42-5. doi: 10.1016/s0003-3944(00)00455-7.
The aim of this retrospective, nonrandomized study was to compare the results of diverticulectomy and diverticulopexy in the treatment of Zenker's diverticulum. Over the 10-year period between 1988 and 1998, surgery for Zenker's diverticulum was performed in 40 patients.
The study group consisted of 23 men and 17 women with a mean age of 72 years. Only 39 patients were evaluated. In 19 patients, treatment consisted of cricopharyngeal myotomy and diverticulum suspension; in the other 19 patients, treatment consisted of diverticulectomy in addition to myotomy. Only one patient had a diverticulectomy without myotomy.
There was no mortality and the morbidity rate was low: one fistula, one pneumonia, three cases of transient dysphonia and one hematoma. The results were excellent in 36 patients, and good in 3 patients.
Cricopharyngeal myotomy with diverticulopexy is particularly suitable for geriatric patients. Diverticulectomy is proposed in the case of a diverticulum larger than 6 cm and for young patients to prevent the risk of malignant transformation.
这项回顾性、非随机研究的目的是比较憩室切除术和憩室固定术治疗Zenker憩室的效果。在1988年至1998年的10年期间，对40例患者进行了Zenker憩室手术。
研究组包括23名男性和17名女性，平均年龄72岁。仅对39例患者进行了评估。19例患者的治疗包括环咽肌切开术和憩室悬吊术；另外19例患者的治疗包括除肌切开术外的憩室切除术。只有1例患者进行了无肌切开术的憩室切除术。
无死亡病例，发病率低：1例瘘管、1例肺炎、3例短暂性发音障碍和1例血肿。36例患者效果极佳，3例患者效果良好。
环咽肌切开术加憩室固定术特别适合老年患者。对于直径大于6cm的憩室以及年轻患者，建议进行憩室切除术以预防恶变风险。
