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Video-assisted thoracoscopic surgery for large Zenker's diverticulum: report of two cases

Published online by Cambridge University Press:  27 January 2014

A Hay ,
B A Ozdemir ,
Y Soon  and
L Pitkin
A Hay*
Affiliation:
Department of ENT, Royal Surrey County Hospital, Guildford, UK
B A Ozdemir
Affiliation:
Oesophagogastric Unit, Royal Surrey County Hospital, Guildford, UK
Y Soon
Affiliation:
Oesophagogastric Unit, Royal Surrey County Hospital, Guildford, UK
L Pitkin
Affiliation:
Department of ENT, Royal Surrey County Hospital, Guildford, UK
*
Address for correspondence: Mr Ashley Hay, Flat 4, 15 St Philips Rd, Surbiton KT6 4DU, UK Fax: +44 (0)1483 571 122 E-mail: Ashley.hay@doctors.net.uk
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Abstract

Introduction:

Zenker's diverticulum is a propulsion diverticulum in the pharynx. Current practice for the management of symptomatic pharyngeal pouches includes endoscopic pharyngeal stapling, performed trans-orally, and external approaches via a cervical incision. There is no published recommendation on how to approach diverticula with extension into the mediastinum, which may not be adequately treated with the above methods.

Cases:

We describe two cases in which thoracoscopic mobilisation of Zenker's diverticulum was performed using video-assisted thoracoscopic surgery together with traditional transcervical mobilisation and excision of the pouch. This allowed safe surgical access to the inferior limit of the pouch, and delivery of the sac into the neck incision following division of any inferior adhesions (to the great vessels in one case).

Discussion:

In the first report of this technique, we describe a thorough, safe method of dissecting large diverticula that extend into the mediastinum, which minimises the risk to mediastinal structures.

Keywords

Zenker DiverticulumVideo-Assisted Thoracic SurgeryMediastinumPharynxEndoscopy
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 195 - 198
Copyright
Copyright © JLO (1984) Limited 2014 

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