Department of ENT Surgery, University Hospital of Wales, Cardiff, Wales, UK.
Department of ENT Surgery, Glan Clwyd Hospital, Rhyl, Wales, UK.
J Laryngol Otol. 2023 Jul;137(7):718-724. doi: 10.1017/S0022215122002377. Epub 2022 Nov 16.
A literature review and meta-analysis was performed to assess for difference in rate of complications and need for revision surgery between endoscopic stapler-assisted diverticulotomy and endoscopic carbon dioxide laser diverticulotomy. The hypothesis was that endoscopic stapler-assisted diverticulotomy has a lower complication rate but endoscopic carbon dioxide laser diverticulotomy has a lower need for revision surgery.
This was a systematic review of English-language studies comparing endoscopic stapler-assisted diverticulotomy and endoscopic carbon dioxide laser diverticulotomy for the treatment of Zenker's diverticulum. Meta-analysis of results with regard to rate of pharyngeal perforation, major post-operative complication and need for re-operation was performed.
Nine retrospective studies were included with pooled analysis of 417 endoscopic stapler-assisted diverticulotomy and 413 endoscopic carbon dioxide laser diverticulotomy cases. Meta-analysis found no significant difference in rate of pharyngeal perforation, major complication or need for re-operation between the two groups.
This study demonstrated both endoscopic stapler-assisted diverticulotomy and endoscopic carbon dioxide laser diverticulotomy to be a safe alternative to open surgery for Zenker's diverticulum. Both appear to be similar in terms of adverse events and efficacy. The authors recommend either approach, guided by surgeon's preference and experience, where patients are unsuitable for an open surgery approach.
对内镜吻合器辅助憩室切开术和内镜二氧化碳激光憩室切开术治疗 Zenker 憩室的并发症发生率和再次手术需求进行文献回顾和荟萃分析。假设是内镜吻合器辅助憩室切开术的并发症发生率较低，但内镜二氧化碳激光憩室切开术的再次手术需求较低。
这是一项对比较内镜吻合器辅助憩室切开术和内镜二氧化碳激光憩室切开术治疗 Zenker 憩室的英文研究的系统评价。对咽穿孔、主要术后并发症和再次手术需求的结果进行荟萃分析。
纳入了 9 项回顾性研究，共有 417 例内镜吻合器辅助憩室切开术和 413 例内镜二氧化碳激光憩室切开术的患者进行了汇总分析。荟萃分析发现两组在咽穿孔、主要并发症或再次手术需求方面无显著差异。
本研究表明，内镜吻合器辅助憩室切开术和内镜二氧化碳激光憩室切开术都是 Zenker 憩室的安全替代开放手术的方法。两者在不良事件和疗效方面似乎相似。作者建议根据患者是否适合开放手术，由外科医生的偏好和经验来选择这两种方法。
