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[咽食管憩室]

[Pharyngoesophageal diverticulum].

作者信息

Gutschow C A, Bauerfeind P

机构信息

Klinik für Viszeral- und Transplantationschirurgie, Universitätsspital Zürich, Rämistrasse 100, 8091, Zürich, Schweiz.

Klinik für Gastroenterologie und Hepatologie, Unispital Zürich, Zürich, Schweiz.

出版信息

Chirurg. 2017 Aug;88(8):717-728. doi: 10.1007/s00104-017-0472-6.

Abstract

Over the last 20-30 years, treatment of pharyngoesophageal diverticula was subject to a number of fundamental changes. Considering the classical open transcervical approaches, the necessity for myotomy of the upper esophageal sphincter with the goal of interrupting the pathogenesis of the disease has become a standard component of the operation. On the other hand, with the growing popularity of rigid and flexible endoscopic techniques, pharyngoesophageal diverticula are increasingly being treated by gastroenterologists and otorhinolaryngologists, often with the argument of a technically easier and less invasive procedure; however, it remains unclear whether this shift towards endoscopic techniques truly translates into better outcome quality. This aim of this CME article is to summarize the available scientific evidence on the complex pathophysiology, diagnostics and treatment of pharyngoesophageal diverticula and to provide the reader with an updated guide to best clinical practice for diagnostics and treatment.

摘要

在过去的20到30年里,咽食管憩室的治疗发生了一些根本性的变化。考虑到传统的开放经颈手术方法,为打断疾病发病机制而进行食管上括约肌肌切开术已成为手术的标准组成部分。另一方面,随着硬质和柔性内镜技术越来越普及,胃肠病学家和耳鼻咽喉科医生越来越多地采用这些技术来治疗咽食管憩室,他们常常认为这些技术在操作上更简便、侵入性更小;然而,向内镜技术的这种转变是否真的能带来更好的治疗效果仍不明确。这篇继续医学教育文章的目的是总结关于咽食管憩室复杂病理生理学、诊断和治疗的现有科学证据,并为读者提供一份最新的诊断和治疗最佳临床实践指南。

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