Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-08T08:10:17.519Z Has data issue: false hasContentIssue false
  • English
  • Français

Pharyngeal pouch surgery in north Glasgow: NICE (National Institute for Health and Clinical Excellence) practice or not?

Published online by Cambridge University Press:  22 December 2009

J C L Yeo  and
K MacKenzie
J C L Yeo*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary, Scotland, UK
K MacKenzie
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary, Scotland, UK
*
Address for correspondence: Mr Justin C L Yeo, Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, Scotland, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

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.

Conclusion:

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.

Keywords

Zenker's DiverticulumEndoscopic Surgical ProcedureSurgical Stapling
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 5 , May 2010 , pp. 533 - 537
Copyright
Copyright © JLO (1984) Limited 2009

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 Scottish Otolaryngology Society Summer Meeting, 7–8 May 2009, Pitlochry, Scotland, UK.

References

1 Interventional procedure overview of endoscopic stapling of pharyngeal pouch. In: http://www.nice.org.uk/Guidance/IPG22 [27 April 2009]Google Scholar
2Sen, P, Lowe, DA, Farnan, T. Surgical interventions for pharyngeal pouch. Cochrane Database Syst Rev 2006;(3):CD004459Google Scholar
3Mirza, S, Dutt, SN, Minhas, SS, Irving, RM. A retrospective review of pharyngeal pouch surgery in 56 patients. Ann R Coll Surg Engl 2002;84:247–51CrossRefGoogle Scholar
4Casso, C, Lalam, M, Ghosh, S, Timms, M. Endoscopic stapling diverticulotomy: an audit of difficulties, outcome, and patient satisfaction. Otolaryngol Head Neck Surg 2006;134:288–93CrossRefGoogle ScholarPubMed
5Lieder, A, Nasseri, F, Sharma, A, Jani, P. Safety and efficacy of endoscopic pharyngeal pouch stapling in a large UK study. Clin Otol 2008;33:127–30CrossRefGoogle Scholar
6Krespi, Y, Kacker, A, Remacle, M. Endoscopic treatment of Zenker's diverticulum using CO2 laser. Otolaryngol Head Neck Surg 2002;127:309–14CrossRefGoogle ScholarPubMed
7Hoffmann, M, Scheunemann, D, Rudert, HH, Maune, S. Zenker's diverticulotomy with the carbon dioxide laser: perioperative management and long-term results. Ann Otol Rhinol Laryngol 2003;112:202–5CrossRefGoogle ScholarPubMed
8Visosky, AMB, Parke, RB, Donovan, DT. Endoscopic management of Zenker's diverticulum: factors predictive of success or failure. Ann Otol Rhinol Laryngol 2008;117:531–7CrossRefGoogle ScholarPubMed
9Bradwell, RA, Bieger, AK, Stranchan, DR, Homer, JJ. Endoscopic laser myotomy in the treatment of pharyngeal diverticula. J Laryngol Otol 1997;111:627–30CrossRefGoogle ScholarPubMed
10Gutschow, CA, Hamoir, M, Rombaux, P, Otte, JB, Goncette, L, Collard, JM. Management of pharyngeal (Zenker's) diverticulum: which techniques? Ann Thorac Surg 2002;74:1677–83CrossRefGoogle Scholar
11Miller, FR, Bartley, J, Otto, RA. The endoscopic management of Zenker diverticulum: CO2 laser versus endoscopic stapling. Laryngoscope 2006;116:1608–11CrossRefGoogle ScholarPubMed