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  • 1
    ISSN: 1432-0460
    Keywords: Zenker's diverticulum ; Cervical myotomy ; Diverticulectomy ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surgery for the treatment of Zenker's diverticulum was performed at our institution in a total of 43 patients over 6½ years. Cervical myotomy with diverticulectomy was performed in 32 of the patients and myotomy alone in 11. Mortality totaled 0%, with a reversible lesion of the recurrent nerve occurring in 7%. In 60% of the cases investigated preoperatively (N=40), motility disorders of the upper esophageal sphincter (UES) could be demonstrated using manometry as well as with cineradiography in 92% of the patients. Follow-up studies in 39 of the cases 25 months (mean) postprocedure indicated 82% of the patients to be symptom-free, with the remaining 18% demonstrating a marked improvement. Postoperative manometry as well as cineradiography carried out in 12 patients revealed the presence of UES motility dyscoordination in 8% and 25%, respectively. There were, however, no signs of recurrence of the diverticulum. The high number of patients in our study group demonstrating motility disorders of the UES emphasizes the need for cervical myotomy as part of the surgical therapy for Zenker's diverticulum.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Chirurg 70 (1999), S. 753-756 
    ISSN: 1433-0385
    Keywords: Key words: Zenker's diverticulum ; Cervical myoptomy ; Diverticulectomy ; Diverticulopexy. ; Schlüsselwörter: Zenker Divertikel ; cervikale Myotomie ; Divertikulektomie ; Divertikulopexie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Die klassische chirurgische Behandlung des Zenker-Divertikels umfaßt die Abtragung des Divertikels und die cervicale Myotomie. Bei sehr kleinen Divertikeln ist die alleinige Myotomie ausreichend. Die Komplikationsrate des Eingriffs ist akzeptabel; die langfristigen funktionellen Ergebnisse sind mit einer Erfolgswahrscheinlichkeit von 90 % über 5 Jahre gut. Trotz der zunehmenden Bedeutung alternativer Verfahren wird die konventionelle extraluminale Operation das Verfahren der Wahl bei Divertikeln der Stadien I–III bleiben.
    Notes: Summary. The classical surgical approach for the treatment of Zenker's diverticulum consists of diverticulectomy and cervical myotomy. In very small diverticula myotomy alone is sufficient. The complication rate of the procedure is tolerable. Long-term functional results are good in as much as 90 % and more. Despite the increasing importance of alternative approaches, the conventional extraluminal surgical operation for Zenker's diverticulum will remain the treatment of choice in stage I–III cases.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 375 (1990), S. 166-170 
    ISSN: 1435-2451
    Keywords: En-bloc esophagectomy ; Esophageal cancer ; Reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven Studie wurde die einzeitige Speiseröhrenrekonstruktion mit der 4872 h nach Oesophagektomie durchgeführten verglichen. In beiden Gruppen (26/24 Patienten) wurde eine transthorakale en-bloc Oesophagektomie durchgeführt. Als weitere Vergleichsgruppe wurden 45 Patienten mit transmediastinaler Oesophagektomie and einzeitiger Rekonstruktion, die ebenfalls während der Studiendauer operiert wurden, herangezogen. Es ergaben sich in Hinblick auf postoperative Komplikationen (26,9%; 29,1%; 22,2%) and auf die postoperative 30-Tage-Letalität (0%; 4,1%; 2,1%) sowie die Kliniksletalität (3,2%; 4,1%; 4,2%) keinerlei Unterschiede. Somit führt die Rekonstruktion mit aufgeschobener Dringlichkeit zu keiner weiteren Risikoverminderung; andererseits stellt sie aber auch keine Risikoerhöhung dar, so daß sie in das Verfahrensspektrum der Oesophaguschirurgie aufgenommen werden kann.[/p]
    Notes: Summary In a prospective study direct reconstruction of the esophagus was compared to reconstruction 48–72 h after esophagectomy. In both groups (26/24) transthoracic en-bloc esophagectomy was performed. During the same time period of the study another group of 45 patients had transmediastinal esophagectomy and direct reconstruction and this group was also used as comparison. There were no differences concerning postoperative complications (26.9%; 29.1 %; 22.2%), postoperative 30-days mortality (0%; 4.1%; 2.1%), and hospital mortality (3.2%; 4.1%; 4.2%). Thus reconstruction with delayed urgency does not lead to a further decrease of risk; on the other hand there is also no increase of risk and therefore it can be included in the spectrum of procedures of esophageal surgery.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 924-924 
    ISSN: 1435-2451
    Keywords: Esophageal carcinoma ; En-bloc esophagectomy ; Mediastinal lymphadenectomy ; Esophagogastrostomy ; Oesophaguscarcinom ; En-bloc-Oesophagektomie ; Mediastinale Lymphadenektomie ; Oesophago-Gastrostomie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der Film zeigt die Technik der en-bloc-Oesophagektomie beim Oesophaguscarcinom. Bei dieser Operationstechnik werden der Oesophagus nebst angrenzendem mediastinalem Lymph- und Fettgewebe inclusive der V. azygos und des Ductus thoracicus entfernt. Diese Ausräumung des Mediastinums führt zu einer mediastinalen Lymphadenektomie. Zusätzlich werden Ausmass und Technik der abdominellen Lymphadenektomie gezeigt. Die Rekonstruktion der Speisepassage erfolgt durch Mageninterposition mit cervicaler Oesophago-Gastrostomie.
    Notes: Summary The film shows the technique of en-bloc esophagectomy in esophageal carcinoma. With this surgical technique it is possible to resect the esophagus with the surrounding lymphatic and fatty tissue, including the azygos vein and the thoracic duct. This mediastinectomy leads to a regional lymphadenectomy. In addition, the extent and technique of abdominal lymphadenectomy are also shown. Reconstruction of the food passageway is done by gastric interposition with cervical esophagogastrostomy.
    Type of Medium: Electronic Resource
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