DIVERTICULE DE ZENKER PDF
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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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. Zenker diverticulum is the most common proof of a primitive pharyngo-esophageal motility disorder. 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.
A combination of the simple barium swallow and a thorough endoscopy will normally confirm the diverticulum. Thyropharyngeus and cricopharyngeus are the superior and inferior parts of inferior constrictor muscle of pharynx respectively. On the other hand, postoperative fistula at this level has a good prognosis under conservative treatment, being enough wide drainage by opening the cervical wound and NPO, with the healing of the leak in a couple of days.
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 diverrticule diverticulum, as well as the identification and interception of the pathological mechanisms by the therapeutic gesture.
Access to the text HTML. Surg Clin North Am. Esophagus and Diaphragmatic Hernia. Belsey Functional disease of the esophagus. Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum.
Long term results were hard to obtain due to short monitoring period in more than half of the patients. divertidule
The change in direction of the muscular fibers, from circular at the esophagus, to oblique at the stomach, makes it difficult to develop the necessary submucosal plane for dividing the divertciule fibers.
Surgical management of esophageal motility disturbances. Diverticulectomy is proved to be the most efficient method of alleviating dysphagia [ 18 ], compared with the simple myotomy or diverticuls associated with diverticulopexy [ 17 ].
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B DallemagneJ Marescaux. The McGraw-Hill Companies; Diverticula of the esophagus. The patients with Zenker diverticulum frequently associate hiatal hernia. B DallemagneS Perretta. The diagnosis was zenmer on a clinical picture severe dysphagia, regurgitations, weight loss and investigations barium passage, upper endoscopy. Other methods include fibreoptic diverticular repair. The indication for surgical treatment was based on the severe dysphagia, which may dde in more than half of the patients, important weight loss.
Laparoscopic excision of a horseshoe-shaped leiomyoma of the lower esophagus. We have resected the diverticular pouch, an attitude that we consider good for improving dysphagia and preventing stasis complications and malignant transformation.
Operating room set up, position of patient and equipment, idverticule used are thoroughly described. Laimer’s diverticulum is formed in Laimer’s triangle located inferior to the cricopharyngeus in the posterior midline above the confluence of the longitudinal layer of esophageal muscle. The authors present a case of a laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction in a woman with long-term achalasia and megaesophagus.
Regardless of the type and cause of the pharyngo-esophageal motor abnormalities, most of the authors agree that the existence of the diverticulum at this level is the consequence of the intraluminal rise of the pressure, related to the resistance of the esophageal wall.
An esophageal leiomyoma can be enucleated safely and effectively through minimally invasive surgery. The patient had previously undergone neoadjuvant chemoradiotherapy with poor results. This is considered the most important part of the surgical treatment by many authors [ 1921 ].
The different incidence related to race or geographic area and the communicated familial cases may suggest the implication of a genetic mechanism. Back in theSchmid communicated the diverticulopexy, with lower morbidity and mortality compared with the resection. Long-term results of endosurgical and open surgical approach for Zenker diverticulum. The diagnosis is suspected based on clinical symptoms and easily confirmed by imaging studies available almost everywhere barium passage and upper endoscopy.
Surgical management of posterior pharyngeal pulsion diverticula: Esophageal peptic stricture and shortened esophagus managed by a laparoscopic Collis-Nissen procedure.
Diverticulopexie pour diverticule de Zenker – EM|consulte
This procedure does not require the opening of the esophageal mucosa, reducing the risk of developing fistula or stenosis, but includes myotomy. Restoration of digestive continuity was achieved through an intrathoracic esophagogastric anastomosis once the stomach has been tubulized. The video demonstrates the freedom zenjer movement of the articulated robotic instruments that allow the surgeon to divide each individual muscular fiber achieving a precise dissection of the gastroesophageal junction.
We never used transoral approach, minimally invasive, promoted by some d but dependent on expensive resources and difficult learning curve. J Thorac Cardiovasc Surg.
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 ].
The patient was admitted to hospital and further study was performed –esophagogastroscopy and esophageal manometry – which confirmed the diagnosis of achalasia with esophageal aperistalses.
Ddiverticule Hematemesis Melena Lower Hematochezia. InHarrison added myotomy in the surgical protocol of Zenker diverticulum [ 1112 ]. Surgical indication must be carefully established, after thorough evaluation. InCollard introduced diverticulotomy by using the endostapler, which decreased morbidity.
Idiopathic achalasia is the most frequent esophageal motility disorder.