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经黏膜下隧道内镜下隔肌切开术治疗Zenker憩室:两例病例报告

Zenker's diverticulum treated with submucosal tunneling endoscopic septum division surgery: Two case reports.

作者信息

Shen Baile, Jiang Haizhong, Li Zhuoya, Wang Zheng, Song Haojun, Ding Xiaoyun

机构信息

Medical School of Ningbo University.

Department of Gastroenterology, Ningbo First Hospital, Ningbo.

出版信息

Medicine (Baltimore). 2020 Jan;99(5):e18659. doi: 10.1097/MD.0000000000018659.

Abstract

INTRODUCTION

Zenker's diverticulum (ZD) refers to a pouch-like structure similar to the esophageal lumen formed from the herniation of the esophageal mucosa; this structure makes it difficult for food to pass through the esophagus to the stomach. The development of endoscopic technology has made minimally invasive surgical treatments for ZD possible.

PATIENT CONCERNS

A female 72-year-old patient was admitted to our hospital due to recurrent dysphagia for more than 5 years. A 62-year-old female patient underwent a gastroscopic examination due to recurrent dysphagia for 10 years and aggravated dysphagia accompanied by bad breath for 1 year.

DIAGNOSIS

A significant diverticulum with food residue at the entrance of the esophagus was found on gastroscopy in both cases.

INTERVENTIONS

After completing a relevant examination and excluding surgical contraindications, both patients underwent submucosal tunneling endoscopic septum division.

OUTCOMES

Both patients were discharged after symptoms alleviated on postoperative day 4. A 3-month follow-up gastroscopy showed the disappearance of the diverticulum and recovery of the esophageal anatomical structure. No symptom relapse was found at the 6-month follow-up assessment.

CONCLUSION

Submucosal tunneling endoscopic septum division has become the most common minimally invasive treatment option. It is efficient and safe for relieving symptomatic ZD in the short term.

摘要

引言

Zenker憩室(ZD)是指由食管黏膜疝出形成的类似食管腔的袋状结构;这种结构使食物难以通过食管进入胃。内镜技术的发展使ZD的微创手术治疗成为可能。

患者情况

一名72岁女性患者因反复吞咽困难5年以上入院。一名62岁女性患者因反复吞咽困难10年,且吞咽困难加重伴口臭1年接受胃镜检查。

诊断

两例患者胃镜检查均发现食管入口处有一个有食物残渣的巨大憩室。

干预措施

完成相关检查并排除手术禁忌证后,两名患者均接受了黏膜下隧道内镜憩室分隔术。

结果

两名患者均在术后第4天症状缓解后出院。术后3个月的胃镜检查显示憩室消失,食管解剖结构恢复。6个月随访评估未发现症状复发。

结论

黏膜下隧道内镜憩室分隔术已成为最常见的微创治疗选择。它在短期内缓解有症状的ZD方面高效且安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8db8/7004738/5f815e172ced/medi-99-e18659-g001.jpg

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