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[复发性Zenker憩室及术后食管狭窄的内镜治疗]

[Endoscopic treatment of recurrent Zenker diverticulum and postoperative esophageal stricture].

作者信息

Starkov Yu G, Vagapov A I, Badakhova A B, Zamolodchikov R D, Dzhantukhanova S V

机构信息

Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.

出版信息

Khirurgiia (Mosk). 2024(3):70-75. doi: 10.17116/hirurgia202403170.

Abstract

Zenker diverticulum is a rare disease accounting for 1.5-5% of esophageal diverticula. For a long time, surgical treatment of Zenker pharyngoesophageal diverticula implied open diverticulectomy via cervical approach. However, this intervention is characterized by high postoperative morbidity and recurrence rate. Oral endoscopic minimally invasive cricopharyngoesophagomyotomy has become widespread over the past 10 years. We present a 55-year-old female who underwent endoscopic treatment for recurrent Zenker diverticulum and postoperative esophageal stricture. We obtained favorable result in a patient with recurrent Zenker diverticulum after previous open surgeries complicated by esophageal stricture. Endoscopic management eliminated recurrent diverticulum and esophageal stricture, as well as improved the quality of life. Endoscopic approach is preferable for pharynoesophageal diverticula compared to traditional surgical diverticulectomy. Obvious advantages of this technique are stable functional result, low incidence of complications and mortality, short-term postoperative period with fast rehabilitation. Extended myotomy is essential for successful oral endoscopic cricopharyngoesophagomyotomy.

摘要

Zenker憩室是一种罕见疾病,占食管憩室的1.5%至5%。长期以来,Zenker咽食管憩室的手术治疗意味着通过颈部入路进行开放性憩室切除术。然而,这种干预的特点是术后发病率和复发率高。在过去10年中,经口内镜微创环咽食管肌切开术已广泛应用。我们报告一名55岁女性,她接受了内镜治疗复发性Zenker憩室和术后食管狭窄。我们在一名先前接受开放性手术并发食管狭窄的复发性Zenker憩室患者中取得了良好效果。内镜治疗消除了复发性憩室和食管狭窄,并改善了生活质量。与传统手术憩室切除术相比,内镜治疗方法更适合咽食管憩室。该技术的明显优点是功能结果稳定、并发症和死亡率发生率低、术后短期恢复快。扩大肌切开术对于成功进行经口内镜环咽食管肌切开术至关重要。

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