Istituto Oncologico Veneto IOV-IRCCS, via Gattamelata 64, 35128 Padova, PD, Italy.
Surg Endosc. 2012 Jul;26(7):2010-5. doi: 10.1007/s00464-012-2146-2. Epub 2012 Jan 25.
Zenker's diverticulum (ZD) may be treated with a variety of endoscopic or open surgical techniques; the choice of treatment depends partly on the size of the diverticulum. The purpose of this study was to correlate ZD measurements obtained preoperatively and during surgery.
From March 2006 to November 2008, 20 consecutive patients (19 males; median age 64.5 (range 37-88) years) with dysphagia secondary to ZD were enrolled for this study. All patients had preoperative barium radiography of the pharynx and esophagus, and diagnostic endoscopy. Ten patients underwent transoral stapling diverticulostomy and ten had open surgery. The depth of the ZD was measured on radiographic views, at endoscopy and during surgery, focusing on the distance from the top of the septum to the bottom of the pouch. The ZD dimensions obtained radiologically and endoscopically were compared with those found during surgery. Correlations and agreements between measurements were assessed using Pearson's correlation coefficients and method-comparison analysis, respectively.
The median depth of the ZD was 2.9 cm (mean 2.95 ± 1.12 cm; range 1.5-6 cm), 3.0 cm (mean 3.24 ± 1.27 cm; range 1.7-6.8 cm), and 3.0 cm (mean 2.99 ± 1.01 cm; range 1.5-6 cm) when measured during surgery, radiology, and endoscopy, respectively. The correlation and agreement between the radiographic and surgical ZD measurements were good, whereas those between the endoscopic and surgical measurements were poor.
These findings confirm that preoperative barium radiography is mandatory in order to choose the most appropriate surgical treatment for ZD.
Zenker 憩室（ZD）可以通过多种内镜或开放手术技术进行治疗；治疗方法的选择部分取决于憩室的大小。本研究的目的是对术前和术中获得的 ZD 测量值进行相关性分析。
2006 年 3 月至 2008 年 11 月，连续纳入 20 例因 ZD 导致吞咽困难的患者（19 例男性；中位年龄 64.5 岁（范围 37-88 岁））。所有患者均行咽部和食管钡餐造影及诊断性内镜检查。10 例行经口吻合器憩室切开术，10 例行开放手术。在影像学、内镜和手术中测量 ZD 的深度，重点测量隔顶至囊袋底部的距离。对影像学和内镜获得的 ZD 尺寸与术中发现的尺寸进行比较。使用 Pearson 相关系数和方法比较分析分别评估测量值之间的相关性和一致性。
ZD 的中位深度为 2.9cm（平均 2.95 ± 1.12cm；范围 1.5-6cm）、3.0cm（平均 3.24 ± 1.27cm；范围 1.7-6.8cm）和 3.0cm（平均 2.99 ± 1.01cm；范围 1.5-6cm），分别在手术、放射学和内镜下测量。放射学和手术 ZD 测量值之间的相关性和一致性良好，而内镜和手术测量值之间的相关性和一致性较差。
这些发现证实术前钡餐造影对于选择最适合 ZD 的手术治疗至关重要。
