Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Zenker Divertikülü: 20 Yıllık Tecrübe ve Cerrahi Rezeksiyon Sonuçları
Zenker's Diverticulum: 20 Years of Experience and Outcomes of Surgical Resection
Server Sezgin ULUDAĞa, Deniz Esin TEKCAN ŞANLIb, Nazım GÜREŞc, Ahmet Necati ŞANLIa, Abdullah Kağan ZENGİNa
aDepartment of General Surgery, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, TURKEY
bClinic of Radiology, Acıbadem Kozyatağı Hospital, İstanbul, TURKEY
cClinic of General Surgery, Balıkesir Atatürk City Hospital, Balıkesir, TURKEY
Turkiye Klinikleri J Med Sci. 2021;41(2):119-24
doi: 10.5336/medsci.2020-79320
Article Language: TR
Full Text
ÖZET
 Amaç: Zenker divertikülü (ZD), genellikle yaşlı popülasyonda görülen nadir bir özofagus hastalığıdır. Geleneksel transservikal divertikülotomi (TD), yerini son yıllarda başarılı sonuçlar verdiği bildirilen endoskopik divertikülotomiye (ED) bıraksa da cerrahi tedavi hâlen tercih edilen tedavi seçeneğidir. Bu çalışmada, 20 yıllık cerrahi serimizin sonuçlarını sunmayı amaçladık. Gereç ve Yöntemler: 1999-2019 yılları arasında ZD nedeniyle ameliyat edilen hastaların verilerini geriye dönük olarak gözden geçirdik. Hastaların demografik verileri, semptomları, ameliyat tipi ve postoperatif komplikasyonları incelendi. Bulgular: Çalışmaya, 18 hasta dâhil edildi. Hastaların %89'unda (16/18) ameliyat öncesi başlıca şikâyet disfaji idi. Tüm hastalara, açık cerrahi yaklaşım uygulandı. On yedi hastaya divertikül eksizyonu, 1 hastaya divertikülopeksi yapıldı. Üç hastada, postoperatif majör komplikasyonlar görüldü. Tekrarlayan divertikül ile ameliyat edilen 1 hasta dışında tüm hastalar semptomlarında düzelme ile taburcu edildi. Bu hastada, özofagus darlığı gelişti ve perkütan endoskopik gastrostomi gerekti. Sonuç: ZD tedavisinde, endoskopik tedavi yöntemleri giderek daha fazla kullanılsa da cerrahi tedavi hâlen başarılı sonuçlarla bir seçenektir ve ZD tedavisinde tercih edilen yöntem olarak yerini korumaktadır. Tekrarlayan ZD vakalarında, cerrahi de öncelikli seçenektir.

Anahtar Kelimeler: Zenker's diverticulum; diverticulopexy; transcervical diverticulectomy; endoscopy, digestive system; diverticulum, esophageal
ABSTRACT
 Objective: Zenker's diverticulum (ZD) is a rare esophageal disorder usually seen in the elderly population. Although traditional transcervical diverticulectomy (TD) has been replaced by endoscopic diverticulectomy (ED), which have been reported to have successful results in recent years, surgical treatment is still the preferred treatment option. We aimed to present the outcomes of our surgical series of 20 years in this study. Material and Methods: We retrospectively reviewed the data of patients operated due to ZD between 1999 and 2019. Demographic data, symptoms, type of surgery, and postoperative complications of the patients were analyzed. Results: Eighteen patients were included in the study. Dysphagia was the main complaint in 89% (16/18) of patients preoperatively. Open surgical approach was applied to all patients. Diverticula excision was performed in 17 patients and diverticulopexy was performed in 1 case. Major postoperative complications were observed in 3 patients. All patients were discharged with improvement in their symptoms except one patient who was operated with recurrent diverticulum. In this patient, oesophageal stricture was developed and percutaneous endoscopic gastrostomy was needed. Conclusion: Although endoscopic therapeutic methods are used increasingly in the treatment of ZD, surgical treatment is still an option with successful results and retains its place as the preferred method in the treatment of ZD. Surgery is also the prior option of recurrent ZD cases.

Keywords: Zenker divertikülü; divertikülopeksi; transservikal divertikülotomi; endoskopi, sindirim sistemi; divertikül, özofageal
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