Skip to main content
SpringerLink
Log in

A follow up audit of pharyngeal pouch surgery using endoscopic stapling

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The aim of this study is to assess patient satisfaction, success at controlling symptoms and conversion rates to open surgery in patients undergoing pharyngeal pouch surgery using an endoscopic stapler in a second cycle of audit. The design consisted of a review of patient records augmented by an electronic search of operation codes in the hospitals’ theatre records. The setting was in Worcester Royal Hospital, BUPA Southbank Hospital and Hereford Hospital, UK. Participants include all patients with pharyngeal pouches undergoing endoscopic pharyngeal pouch repair by the senior author between July 2002 and July 2007. The total number of participants was 31. All patients were undergoing treatment for the first time. The main outcome measures were pre- and postoperative symptom prevalence, conversion rates to open surgery, patient satisfaction. Endoscopic pharyngeal pouch surgery was successful in the vast majority of cases, with 97% of patients being satisfied with the result. The conversion rate to open surgery was 9.7%. These figures are improved from the last round of audit. In conclusion, endoscopic surgery to treat pharyngeal pouches is safe, effective and patient selection is improving. A modified method of endoscopy using a Negus scope rather than a Baldwin scope has allowed more patients to be treated via endoscopic methods. Open surgery is still required in some patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ludlow AA (1769) A case of obstructed deglutition from a preternatural dilatation of a bag formed in the pharynx. Med Obs Enq 3:85–101

    Google Scholar 

  2. Zenker FA (1878) Handbuch der Krankhauten des Chylopoetischen Apparates. Leipzig

  3. Van Overbeek JJ (2003) Pathogenesis and methods of treatment of zenker’s diverticulum. Ann Otol Rhinol Laryngol 112(7):583–593

    PubMed  Google Scholar 

  4. Norris CW (1979) Pharyngocoeles of the hypopharynx. Laryngoscope 89:1788–1807

    Article  CAS  PubMed  Google Scholar 

  5. Siddiq MA, Sood S (2004) Current management in pharyngeal pouch surgery by UK otorhinolaryngologists. Ann R Coll Surg Engl 86(4):247–252

    Article  CAS  PubMed  Google Scholar 

  6. Mosher HP (1917) Webs and pouches of the oesophagus, their diagnosis and treatment. Surg Gynaecol Obstet 25:175–187

    Google Scholar 

  7. Dohlman G (1949) Endoscopic operations for hypopharyngeal diverticula. In: Proceedings of the 4th international congress of otolaryngology London, vol 2, pp 715–717

  8. Benjamin B, Innocenti M (1991) Laser treatment of pharyngeal pouch. Aust N Z J Surg 61(12):909–913

    Article  CAS  PubMed  Google Scholar 

  9. Collard J-M, Otte J-B, Kestens PJ (1993) Endoscopic stapling technique of esophagodiverticulostomy for Zenker’s diverticulum. Ann Thorac Surg 56(3):573–576

    Article  CAS  PubMed  Google Scholar 

  10. Smith SR, Genden EM, Urken ML (2002) Endoscopic stapling technique for the treatment of Zenker diverticulum vs standard open-neck technique: a direct comparison and charge analysis. Arch Otolaryngol Head Neck Surg 128(2):141–144

    PubMed  Google Scholar 

  11. van Eeden S, Lloyd RV, Tranter RM (1999) Comparison of the endoscopic stapling technique with more established procedures for pharyngeal pouches: results and patient satisfaction survey. J Laryng Otol 113(3):237–240

    Google Scholar 

  12. Weller MD, Porter MJ, Rowlands J (2003) An audit of pharyngeal pouch surgery using endoscopic stapling. The patients viewpoint. Eur Arch Otorhinolaryngol 261:331–333

    PubMed  Google Scholar 

  13. Chang CWD et al (2004) Carbon dioxide laser endoscopic diathermy versus open diverticulectomy for Zenker’s diverticulum. Laryngoscope 114(3):519–527

    Article  PubMed  Google Scholar 

  14. Lieden A, Nasseri F, Sharma A, Jani P (2008) Safety and efficacy of endoscopic pharyngeal pouch stapling in a large UK study. Clin Otolaryngol 33(2):127–130

    Article  Google Scholar 

  15. Aly A et al (2003) Endoscopic stapling for pharyngeal pouch: does it make the cut? ANZ J Surg 74(3):116–121

    Article  Google Scholar 

  16. Flikweert DC, van der Baan S (1992) Endoscopic treatment of pharyngeal pouches: electrocoagulation vs carbon dioxide (CO2) laser. Clin Otolaryngol 17(2):122–124

    Article  CAS  PubMed  Google Scholar 

  17. NICE (2002) Endoscopic stapling of pharyngeal pouch. http://guidance.nice.org.uk/IPG22

  18. Tang SJ, Jazrawi SF, Chen E, Tang L, Myers LL (2008) Flexible endoscopic clip-assisted Zenker’s diverticulotomy: the first case series (with videos). Laryngoscope 118(7):1199–1205

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Worcester Acute Hospitals NHS Trust, Worcester, UK

    Richard P. Harris, Matt D. Weller & Martin J. Porter

  2. Flat 4, Stuart House, 4 Olive Shapley Avenue, Didsbury, Manchester, M20 6QE, UK

    Richard P. Harris

Authors
  1. Richard P. Harris
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matt D. Weller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin J. Porter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard P. Harris.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harris, R.P., Weller, M.D. & Porter, M.J. A follow up audit of pharyngeal pouch surgery using endoscopic stapling. Eur Arch Otorhinolaryngol 267, 939–943 (2010). https://doi.org/10.1007/s00405-009-1158-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-009-1158-6

Keywords

Search

Navigation