https://scholars.lib.ntu.edu.tw/handle/123456789/641506
標題: | Diagnosis and Ttreatment of Esophageal Fiverticulum: An Update | 作者: | Yuan, Ming Ching Chou, Chu Kuang CHIEN-CHUAN CHEN HSIU-PO WANG PING-HUEI TSENG |
公開日期: | 1-十二月-2023 | 卷: | 34 | 期: | 6 | 起(迄)頁: | 437 | 來源出版物: | Journal of Internal Medicine of Taiwan | 摘要: | Esophageal diverticulum is an uncommon structural disorder that manifests as dysphagia, esophageal stuck sensation, foul breath, acid reflux, heartburn, chronic cough, and has been related to recurrent pneumonia, bleeding and esophageal cancer. Some asymptomatic patients are found accidentally on endoscopy. The pathophysiology of esophageal diverticulum varies based on its location of the esophagus. Zenker's diverticulum is associated with impaired upper esophageal sphincter relaxation, while middle esophageal diverticulum is related to traction or pulsion. Epiphrenic diverticulum is mostly related to pulsive factors and esophageal dysmotility. Diagnosis of esophageal diverticulum include an upper endoscopy, barium esophagography, computed tomography, and high-resolution manometry (HRM). HRM helps to clarify potential esophageal motility abnormalities underlying the esophageal diverticulum, which may affect the treatment strategy. Traditionally, Zenker diverticulum is treated with surgical or endoscopic treatment, and the latter is suitable for the elderly and patients with multiple comorbidities for its lower complication rates. The treatment strategy of pulsive Rokitansky diverticulum and epiphrenic diverticulum are similar. Laparoscopic approach is associated with lower complication rates than thoracotomy. Recently, the efficacy and safety of peroral endoscopic myotomy (POEM) have been demonstrated in the management of Zenker's diverticulum and epiphrenic diverticulum. More long-term follow-up studies are awaited. |
URI: | https://www.scopus.com/record/display.uri?eid=2-s2.0-85184617671&doi=10.6314%2fJIMT.202312_34%286%29.03&origin=inward&txGid=ed227c9e8be480b77659df60ed2350f0 https://scholars.lib.ntu.edu.tw/handle/123456789/641506 |
ISSN: | 10167390 | DOI: | 10.6314/JIMT.202312_34(6).03 |
顯示於: | 醫學系 |
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