倒悬固定法治疗Zenker憩室(附11例报道)

Surgical management of esophageal diverticula by end-up suspension

目的 探讨Zenker憩室倒悬固定法在治疗Zenker憩室中的效果及安全性。方法 11例Zenker憩室患者中,9例为甲状腺肿瘤手术中意外发现为Zenker憩室,2例为术前确诊为Zenker憩室。9例予以外科干预,术中沿Zenker憩室表面全周游离后,将憩室底部上提并将底部及内侧壁与下咽缩肌和环甲肌分别缝合固定。结果 口腔异味症状消失或显著改善者8例,改善不明显者3例（2例未行手术）;刺激性咳嗽显著改善者2例,症状减轻者2例;3例食管残渣反流者症状均消失。随访6~46个月,未见症状复发者,无喉返神经或喉上神经麻痹者,无食管瘘或术后感染者。结论 憩室倒悬固定法治疗Zenker憩室简便安全,疗效较好,值得进一步探讨。

Objective To evaluate the efficiency and safety of end-up suspension in the management of esophageal diverticulum.Methods Eleven cases of esophageal diverticulum were retrospectively analyzed.Esophageal diverticulum was unexpectedly found in 9 cases during operation on thyroid,and was confirmed preoperatively in the other two.After necessary exposure and isolation,the end of diverticulum was suspended and then sutured to the inferior phargngeal constrictor and cricothyroid muscle.Results Significant improvement of symptoms was found in 8 of the 11 cases,there was no improvement of symptoms in 3 cases.No relapse was noted during the follow-up period of 6-46 months.There was no damage to the function of the recurrent laryngeal nerve or superior laryngeal nerve.Fistula or operation associated infection was not noted.Conclusions End-up suspension is a relatively ideal approach for esophageal diverticulum.