Journal de Chirurgie Viscérale – Vol. – N° 4 – p. – Diverticulopexie pour diverticule de Zenker – EM|consulte. A Zenker’s diverticulum, also pharyngoesophageal diverticulum, also pharyngeal pouch, also hypopharyngeal diverticulum, is a diverticulum of the mucosa of. Keywords: Zenker, esophageal diverticulum, diverticulectomy, .. M. Diverticule pharyngo- oesophagien de zenker a propos de cinq cas.
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Consequently, this operating technique is well standardized for the management of this condition. All the patients included in the study underwent surgical treatment. Laparoscopic transhiatal enucleation is a safe and feasible procedure. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
The laparoscopic approach is a conventional option for this kind of tumor located near or at the esophagogastric EG junction. The video demonstrates the freedom of movement of the articulated robotic instruments divertlcule allow the surgeon to divide each individual muscular fiber achieving a precise dissection of the gastroesophageal junction.
Other methods include fibreoptic diverticular repair. Thyropharyngeus and cricopharyngeus are the superior and inferior parts of inferior constrictor muscle of pharynx respectively.
This process demonstrated at immuno-histochemistryalso affects the muscularis propria layer of the cervical esophagus [ 56 ]. During that period, more patients were diagnosed with this pathology, but the surgical indication was carefully established, in conformity with the actual practice guides, which involve the evaluation of the clinical manifestations determined by the diverticulum, ve well as the identification and interception of the pathological mechanisms by the therapeutic gesture.
The opponents of this technique rise attention about the risk of abandoning a possible malignant lesion inside the pouch, on one side and on the other side, that the resection is not much more complicated than diverticulopexy [ 1617 ]. Long-term results of endosurgical and open surgical approach for Zenker diverticulum.
Principles of surgical treatment of Zenker diverticulum
Journal page Archives Contents list. This video describes an esophagectomy performed laparoscopically and thoracoscopically in a year-old male patient presenting with an epidermoid esophageal carcinoma. Extraesophageal reflux in patients suffering from Zenker’ s diverticulum. Esophageal manometry must be included in the investigations of these patients, on one hand for the assessment of dysphagia and on the other hand for optimization of indication and surgical technique.
The pathologic relationship between these clinical entities can only be speculated. Laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction for a terminal achalasia. In the second operation, it was dw that there was an incomplete myotomy, the correction of the myotomy leading to the healing of the leak [ 20 ]. The diagnosis was based on a clinical picture severe dysphagia, regurgitations, weight loss and investigations barium passage, upper endoscopy.
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A novel technique for the management of Zenker’s diverticulum”. Minimally invazive surgery for Zenker diverticulum: An esophageal leiomyoma can be enucleated safely and effectively through minimally invasive surgery. Open surgery represents the most known approach of this pathology, especially in younger patients, due to long term favorable results communicated.
Esophagectomy as a primary treatment of achalasia might be considered if severe symptomatic dysphagia, regurgitationanatomical megaesophagus or functional esophagus aperistalses disorders are contraindications to a more conservative approach.
Gastric leiomyoma is an uncommonly found benign submucosal neoplasm that may cause bleeding in rare cases. civerticule
Other non-surgical treatment modalities also exist, such as endoscopic laser, which recent evidence suggests is less effective than stapling. In familial cases, the disease seems to have a dominant transmission.
The extension of the myotomy on the gastric side continues to be the most difficult part of the dissection.
It was named in eiverticule German pathologist Friedrich Albert von Zenker. We found useful esophageal manometry, investigation that measures esophageal motility and we have used it recently, after the purchase of the equipment [ 32 ]. More precisely, while traction and pulsion mechanisms have long been deemed the main factors promoting development of a Zenker’s diverticulum, current consensus considers occlusive mechanisms to be most important: Myotomy can be executed on the posterior midline, in order to avoid the relapsing that appears in case of lateral myotomy, before or after approaching the pouch, on cm, and needs to cut the transversal fibers of crico-pharyngeal muscle, cm from the fibers of zenjer pharyngeal constrictor muscle [ 22 ] and 1 cm from the circular muscular layer of the esophagus.
Idiopathic achalasia is the most frequent esophageal motility disorder. This video demonstrates a patient with epiphrenic esophageal diverticulum. Upper Hematemesis Melena Lower Hematochezia. Laimer’s triangle is covered only by the circular layer of esophageal muscle.
The technical key steps of the surgical procedure are presented in a step by step way: Methods Surgical statistics were published duringincluding a group of 11 patients 5 menthat underwent surgical treatment for Zenker diverticulum.
The simple approach of the diverticular pouch through diverticulectomy or diverticulopexy is insufficient, the therapeutic protocol imposes the interception of etiologic mechanisms, esophageal myotomy distal to the diverticular opening being indispensable. National Center for Biotechnology InformationU. Author information Article notes Copyright and License information Disclaimer. No complications were reported in the postoperative period, and discharge was possible on postoperative day 7.
Surgical management of posterior pharyngeal pulsion diverticula: In this lecture, Dr. This should be done as diverhicule as possible, for evacuation.