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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Long term results of endosurgical and open surgical approach for Zenker diverticulum. 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.
This video demonstrates a patient with epiphrenic esophageal diverticulum. Pharyngo-esophageal diverticula are most frequently described in elderly patients, having symptoms such as dysphagia, regurgitation, chronic cough, aspiration and weight loss.
The section of the diverticulum using a linear stapler, followed by one layer of manual suture for safety, simplifies this approach. Upper Hematemesis Melena Lower Hematochezia.
Diverticulopexie pour diverticule de Zenker – EM|consulte
No complications were reported in the postoperative period, and discharge was possible on postoperative day 7. Motility Disorders of the Pharynx and Esophagus. B DallemagneS Perretta. The diagnosis was based on a clinical picture severe dysphagia, regurgitations, weight aenker and investigations barium passage, upper endoscopy. Diverticlue different incidence related to race or geographic area and the communicated familial cases may suggest the implication of a genetic mechanism.
Journal List J Med Life v. The technical key steps of the surgical procedure are presented in a step by step way: Ivor-Lewis esophagectomy with digerticule patient in a left lateral position: This leads to the appearance of a weak area, with the possibility of developing a pharyngo-esophageal diverticulum for the next years after orthopedic surgery [ 8 ].
The septum is cut by using linear endostapler of 35 mm EndoGIAcreating a common cavity, in the same time with zenket section of Upper esophageal sphincter [ 25 ]. We have resected the diverticular pouch, an attitude djverticule we consider good for improving dysphagia and preventing stasis complications and malignant transformation.
As per the Law relating to information storage and personal integrity, you have the right to oppose art 26 of that lawaccess art 34 of that law and rectify art diverticulf of that law your personal data. Received Oct 20; Accepted Jan This procedure does not require the opening of the esophageal mucosa, reducing the risk of developing fistula or stenosis, but includes myotomy.
Results There were 5 men and 6 women, mean age 54 years for men and 60 for women. This article has been cited by other articles in PMC. Click here to access your account, or here to register for free! Views Read Edit View history.
Principles of surgical treatment of Zenker diverticulum
InHarrison added myotomy in the surgical protocol of Zenker diverticulum [ 1112 ]. The simple myotomy as therapy, exposes the patient to specific risks given by the presence of diverticular pouch, including malignant transformation. Barium passage shows the diverticular pouch, giving details about size, localization, retention of contrast, position related to esophageal wall and esophageal motility.
Larger, symptomatic diveerticule of Zenker’s diverticulum have been traditionally treated by neck surgery to resect the diverticulum and dierticule the cricopharyngeus muscle. This video demonstrates a robotic-assisted Heller procedure for treatment of esophageal achalasia.
The patient was proposed a laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction. The conservation of the diverticular pouch after diverticulopexy was for the first time described by Schmid inand made popular by Belsey and Skinner [ 1314 ]. Laparoscopic robotic-assisted Heller procedure for esophageal achalasia.
Top of the page – Article Outline. The simple approach of the diverticular pouch through zsnker or diverticulopexy is insufficient, the therapeutic protocol imposes the interception of etiologic mechanisms, esophageal myotomy distal to divertocule diverticular opening being indispensable.
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: Back in theSchmid communicated the diverticulopexy, with lower morbidity and mortality compared with the resection.
Contact Help Who are we? The technique implies the identification of the diverticulum, dissection of the adhesions with conjunctive tissue to the diverticular opening, which is just superior to the transversal fibers of cricopharyngeal muscle, resection of the pouch and restoration of the esophageal wall by manual suture in one or two layers.
The role of esophageal manometry in the management of the patients with gastro-esophageal reflux disease and Barrett’s esophagus. Not to be confused with Pharyngeal pouch embryology. Long-term results of endosurgical and open surgical approach for Zenker diverticulum.
This video demonstrates all the technical details of a laparoscopic excision of a large horseshoe-shaped leiomyoma of the lower esophagus. Early functional results were favorable in all the cases, with the disappearing of dysphagia.
An esophageal leiomyoma can be enucleated safely and effectively through minimally divertlcule surgery. Diverticulopexy is realized with the sternocleidomastoidian muscle, prevertebral fascia, or exceptionally, the mastoid.