[Use of CO2 laser in endoscopic treatment of Zenker's pharyngo-esophageal diverticula. Experience apropos of 33 cases].
Microendoscopic treatment of hypopharyngeal (Zenker's) diverticulum was performed in 31 patients during the period 1990-1995. The CO2 laser combined with the operating microscope has been used. 33 endoscopic procedures were performed (2 procedures were needed for 2 patients). The average age of the patients was 70.3 years (46-86 years). The average length of the general anesthesia was 48 minutes; the average length of the endoscopic procedure was 20 minutes. No major complication occurred for 32/33 cases (97%). Mediastinitis occurred for 1 case (3%) and was successfully treated by surgical and IV antibiotherapy. The average duration of hospitalization was 5 days (3-5 days) (patient with mediastinitis excluded): the average follow-up was 19 months (1-62 months). 28/31 patients (90.3%) were highly or fairly satisfied. Considering the external approach microendoscopic CO2 laser diverticulotomy offers comparable functional results. Moreover, this procedure is quick, requires a shorter hospitalization stay and is followed by a very low percentage of complications. Additionally, no visible scar is noted. Optimal management of Zenker's diverticulum remains controversial. However, we advocate that microendoscopic CO2 laser diverticulotomy should be considered as a first-line treatment option for patients with hypopharyngeal diverticulum.
Hamoir
M
M
Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Bruxelles, Belgique.
Gruyer
X
X
Rombaux
P
P
D000368:Aged; D000369:Aged, 80 and over; D004240:Diverticulum / Q000601:surgery; D004936:Diverticulum, Esophageal / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000601:surgery*; D012189:Retrospective Studies
Utilisation du laser CO2 dans le traitement endoscopique des diverticules pharyngooesophagiens de Zenker. Expérience à propos de 33 cas.