Pharyngeal pouch surgery in north Glasgow: NICE (National Institute for Health and Clinical Excellence) practice or not?

To evaluate endoscopic pharyngeal pouch surgery practice in north Glasgow by comparing it to National Institute for Health and Clinical Excellence recommendations. We reviewed the case notes of patients who had undergone pharyngeal pouch surgery from 1998 to 2008. Data obtained included patient demo...

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Bibliographic Details
Published in:Journal of laryngology and otology 2010-05, Vol.124 (5), p.533-537
Main Authors: Yeo, J C L, MacKenzie, K
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Endoscopic Surgical Procedure
Endoscopy - adverse effects
Endoscopy - methods
Endoscopy - standards
Female
Humans
Lasers, Gas - adverse effects
Lasers, Gas - therapeutic use
Length of Stay
Male
Medical sciences
Middle Aged
Minimally Invasive Surgical Procedures - adverse effects
Minimally Invasive Surgical Procedures - methods
Minimally Invasive Surgical Procedures - standards
Otorhinolaryngology. Stomatology
Professional Practice - standards
Reoperation - methods
Retrospective Studies
Scotland
Surgical Stapling
Surgical Stapling - adverse effects
Surgical Stapling - methods
Treatment Outcome
Zenker Diverticulum - surgery
Zenker's Diverticulum
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Summary:To evaluate endoscopic pharyngeal pouch surgery practice in north Glasgow by comparing it to National Institute for Health and Clinical Excellence recommendations. We reviewed the case notes of patients who had undergone pharyngeal pouch surgery from 1998 to 2008. Data obtained included patient demographics, procedures performed, complications and outcomes. One hundred patient case notes were reviewed. Surgical procedures performed included endoscopic stapling (n = 58), endoscopic laser surgery (26), external excision (one), cricopharyngeal myotomy (two) and pharyngoscopy with dilatation (three). Endoscopic stapling was abandoned in 10 patients (14.7 per cent), three of whom declined further surgery. There was a 2.2 per cent perforation rate for endoscopic procedures. Twenty-one per cent of patients required further surgery. Our practice was not in keeping with National Institute for Health and Clinical Excellence recommendations. Our complication rates were similar to other published series, although our rates for abandoned and revision procedures were higher. We suggest that pharyngeal pouch surgical procedures should be undertaken only by otolaryngologists with a primary head and neck interest.
ISSN:0022-2151
1748-5460
DOI:10.1017/S002221510999226X