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首页> 外文期刊>Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery >Adverse Events after Rigid and Flexible Endoscopic Repair of Zenker's Diverticula: A Systematic Review and Meta-analysis
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Adverse Events after Rigid and Flexible Endoscopic Repair of Zenker's Diverticula: A Systematic Review and Meta-analysis

机译：Zenker憩室的刚性和灵活内窥镜修复后的不良事件：系统评价和荟萃分析

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Objective To determine adverse events after endoscopic flexible vs endoscopic rigid cricopharyngeal myotomy for treatment of Zenker's diverticulum (ZD). Data Sources Systematic review of MEDLINE, Web of Science, CINAHL, Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials for all years according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additional studies were identified from review citations and a by hand search of manuscripts referencing ZD. Review Methods A structured literature search was conducted to identify studies for this systematic review. Methodological Index for Non-randomized Studies (MINORS) criteria were applied to assess study quality. For inclusion, each study had to provide data for at least 10 adult patients who had undergone endoscopic ZD repair reporting clear association with the postprocedure course in each case. Data extracted included all reported adverse events, recurrences, follow-up, and operative times. Results In total, 115 studies were included. All but 8 were retrospective case series. Sixty-one reported series of patients after rigid endoscopic stapler repair, 31 after rigid laser repair, and 13 with other rigid endoscopic instruments. Twenty-nine flexible endoscopic studies were included. Mortality, infection, and perforation were not significantly more likely in either the rigid or the flexible group, but bleeding and recurrence were more likely after flexible endoscopic techniques (20% vs <10% and 4% vs 0%, respectively). Dental injury and vocal fold palsy were reported rarely in the rigid endoscopic groups. Conclusions Adverse events are rare after endoscopic Zenker's repair. The flexible approach minimizes exposure limitations and can be completed in some patients without general anesthesia. Transoral rigid approaches result in fewer revision surgeries compared with flexible diverticulotomy.
机译：目的探讨内镜柔性VS内镜刚性脑脊术治疗Zenker憩室（ZD）后的不良事件。根据首选报告项目进行系统评价和荟萃分析（PRISMA）指南，所有多年来，数据来源对Medline，科学，Cinahl，Clinicaltrials.gov和Cochrane中央登记册的系统审查。通过审查引用ZD的手稿和A通过审查引用和A确定其他研究。审查方法进行了结构化文献搜索，以确定对该系统审查的研究。非随机研究（未成年人）标准的方法论指标用于评估研究质量。为了纳入，每项研究必须为至少10名成年患者提供有关内窥镜ZD修复报告清楚结合在每种情况下的成年患者的数据。提取的数据包括所有报告的不良事件，再次发生，随访和操作时间。结果总共包括115项研究。除了8个是回顾性案例系列。六十一条报告的患者刚性内窥镜订书机修复后，31刚性激光修复，13件与其他刚性内窥镜仪器。包括二十九项柔性内窥镜研究。死亡率，感染和穿孔在刚性或柔性组中没有显着更容易，但在柔性内窥镜技术（分别为20％vs <10％和4％vs 0％后，更可能出血和复发。牙科损伤和声带麻痹在刚性内窥镜群体中很少报道。结论内窥镜Zenker修复后不良事件是罕见的。灵活的方法可最大限度地降低暴露限制，并且可以在某些患者中完成，没有全身麻醉。与柔性憩室术相比，传输刚性方法导致更少的修正手术。

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