Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-23T21:16:02.836Z Has data issue: false hasContentIssue false
  • English
  • Français

Is pharyngeal pouch stapling superior to open pharyngeal pouch repair? An analysis of a single institution's series

Published online by Cambridge University Press:  12 August 2016

E Agalato ,
J Jose  and
R J England
E Agalato*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK
J Jose
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK
R J England
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK
*
Address for correspondence: Mr Elisha Agalato, Department of Otolaryngology Head and Neck Surgery, Hull and East Yorkshire Hospitals NHS Trust, Cottingham HU16 5JQ, UK Fax: (44) 01482 624714 E-mail: agalatoe@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Endoscopic stapling has become the primary procedure for pharyngeal pouch surgery because it is quick, less invasive and safe, but less is known about long-term outcomes.

Method:

Medical records were reviewed to compare rates of morbidity, operative failure, symptom control and revision surgery between open and closed procedures.

Results:

A total of 120 pharyngeal pouch procedures, carried out on 97 patients from 2000 to 2014, were studied. These included 80 endoscopic stapling and 40 open procedures. Twelve patients had complications (15 per cent) and there was one mortality (1.2 per cent) in the endoscopic stapling group. Ten patients (25 per cent) developed complications in the open procedure group, with no mortalities. Symptom recurrence was significantly greater in the endoscopic stapling group (26 per cent) than in the open procedure group (7.5 per cent). Multiple surgical procedures were required for 22 endoscopically stapled patients (32 per cent); none were required in the open procedure group. Although the male-to-female ratio for pharyngeal pouch incidence was 2:1, the ratio for multiple surgical procedures was 10:1.

Conclusion:

Endoscopic stapling outcomes are not as good as those following an open approach on long-term follow up, and the early advantages are eliminated if pouch excision is avoided.

Keywords

DiverticulumPharynxSurgical ProceduresEndoscopic
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 9 , September 2016 , pp. 873 - 877
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the ENT departmental audit meeting of Hull and East Yorkshire NHS Trust, 3 October 2014, Cottingham, UK.

References

1 Siddiq, M, Sood, S, Strachan, D. Pharyngeal pouch (Zenker's diverticulum). Postgrad Med J 2001;77:506–11Google Scholar
2 Leong, SC, Wilkie, MD, Webb, CJ. Endoscopic stapling of Zenker's diverticulum: establishing national baselines for auditing clinical outcomes in the United Kingdom. Eur Arch Otorhinolaryngol 2012;269:1877–84Google Scholar
3 Todd, GB. The treatment of pharyngeal pouch. J Laryngol Otol 1974;88:307–15Google Scholar
4 Trible, WM. The surgical treatment of Zenker's diverticulum: endoscopic vs external operation. South Med J 1975;68:1260–2CrossRefGoogle ScholarPubMed
5 MacKay, IS. The treatment of pharyngeal pouch. J Laryngol Otol 1976;90:183–90Google Scholar
6 Parker, AJ, Hawthorne, MR. Endoscopic diverticulotomy versus external diverticulectomy in the treatment of pharyngeal pouch. J R Coll Surg Edinb 1988;33:61–4Google ScholarPubMed
7 Welch, AR, Stafford, F. Comparison of endoscopic diathermy and resection in the surgical treatment of pharyngeal diverticula. J Laryngol Otol 1985;99:179–82Google Scholar
8 Maran, AG, Wilson, JA, Muhanna, AH. Pharyngeal diverticula. Clin Otolaryngol Allied Sci 1986;11:219–25Google Scholar
9 Verdonck, J, Morton, RP. Systematic review on treatment of Zenker's diverticulum. Eur Arch Otorhinolaryngol 2015;272:3095–107Google Scholar
10 Mirza, S, Dutt, SN, Minhas, SN, Irving, RM. A retrospective review of pharyngeal pouch surgery in 56 patients. Ann R Coll Surg Engl 2002;84:247–51Google Scholar
11 Seth, R, Rajasekaran, K, Lee, WT, Lorenz, RR, Wood, BG, Kominsky, A et al. Patient reported outcomes in endoscopic and open transcervical treatment of Zenker's diverticulum. Laryngoscope 2014;124:119–25Google Scholar
12 Chang, C, Payyapilli, R, Scher, R. Endoscopic staple diverticulostomy of Zenker's diverticulum: review of literature and experience of 159 consecutive cases. Laryngoscope 2003;113:957–65Google Scholar