title: Pharyngeal pouch surgery in north Glasgow: NICE (National Institute for Health and Clinical Excellence) practice or not?
abstract: OBJECTIVE
  To evaluate endoscopic pharyngeal pouch surgery practice in north Glasgow by comparing it to National Institute for Health and Clinical Excellence recommendations.
  
  
  METHODS
  We reviewed the case notes of patients who had undergone pharyngeal pouch surgery from 1998 to 2008. Data obtained included patient demographics, procedures performed, complications and outcomes.
  
  
  RESULTS
  One hundred patient case notes were reviewed. Surgical procedures performed included endoscopic stapling (n = 58), endoscopic laser surgery (26), external excision (one), cricopharyngeal myotomy (two) and pharyngoscopy with dilatation (three). Endoscopic stapling was abandoned in 10 patients (14.7 per cent), three of whom declined further surgery. There was a 2.2 per cent perforation rate for endoscopic procedures. Twenty-one per cent of patients required further surgery.
  
  
  CONCLUSIONS
  Our practice was not in keeping with National Institute for Health and Clinical Excellence recommendations. Our complication rates were similar to other published series, although our rates for abandoned and revision procedures were higher. We suggest that pharyngeal pouch surgical procedures should be undertaken only by otolaryngologists with a primary head and neck interest.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary, Scotland, UK.
authors.forename: J C L
authors.initials: JC
authors.lastname: Yeo
authors.forename: K
authors.initials: K
authors.lastname: Mackenzie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000592:standards; D011364:Professional Practice / Q000592:standards*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D012606:Scotland; D017792:Surgical Stapling / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000601:surgery*