内镜下激光辅助憩室切开术与经颈肌切开术治疗Zenker 憩室的跨学科比较。
Interdisciplinary Comparison of Endoscopic Laser-Assisted Diverticulotomy vs. Transcervical Myotomy as a Treatment for Zenker's Diverticulum.
机构信息
Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
出版信息
J Gastrointest Surg. 2020 Sep;24(9):1955-1961. doi: 10.1007/s11605-019-04381-z. Epub 2019 Sep 3.
BACKGROUND
Currently, there are different competing techniques for the treatment of Zenker's diverticulum (ZD). To improve patient selection, we compared endoscopic laser-assisted diverticulotomy (ELAD) with transcervical myotomy (TCM) with regard to possible risk factors for treatment failure.
METHODS
Data of ZD patients (n = 104) treated between 2004 and 2016 with either TCM (38%) or ELAD (62%) were analyzed retrospectively. Univariate and multivariate analyses were performed.
RESULTS
TCM is associated with a higher morbidity (27.8% vs. 10.2%; p = 0.095) but lower recurrence rate (7.3% vs. 19.3%; p = 0.095). Preoperative reflux disease (OR 8.755; p = 0.021) was identified as an independent risk factor for complications.
CONCLUSIONS
Although short-term outcome and symptom relief are similar, TCM tends to have a higher complication rate but better long-term results. Preoperative reflux disease is an independent risk factor for postoperative complications.
背景
目前，Zenker 憩室（ZD）的治疗存在多种竞争技术。为了改善患者选择，我们比较了内镜激光辅助憩室切开术（ELAD）与经颈肌切开术（TCM）在治疗失败的可能危险因素方面的差异。
方法
回顾性分析了 2004 年至 2016 年间接受 TCM（38%）或 ELAD（62%）治疗的 ZD 患者（n=104）的数据。进行了单因素和多因素分析。
结果
TCM 与更高的发病率（27.8%比 10.2%；p=0.095）相关，但复发率较低（7.3%比 19.3%；p=0.095）。术前反流性疾病（OR 8.755；p=0.021）被确定为并发症的独立危险因素。
结论
尽管短期结果和症状缓解相似，但 TCM 往往具有更高的并发症发生率，但长期结果更好。术前反流性疾病是术后并发症的独立危险因素。
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