Characterizing a CT esophagram protocol after flexible endoscopic diverticulotomy for Zenker's diverticulum: a retrospective series.

Autor:	Banerjee D; Department of Medicine, University of Florida, Gainesville, FL, USA., Magnelli LL; Division of Abdominal Imaging, Department of Radiology, University of Florida, Gainesville, FL, USA., Oliva M; College of Medicine, University of Florida, Gainesville, FL, USA., Malik N; College of Medicine, University of Florida, Gainesville, FL, USA., Ginsburg BM; Department of Medicine, University of Florida, Gainesville, FL, USA., Grajo JR; Division of Abdominal Imaging, Department of Radiology, University of Florida, Gainesville, FL, USA., Brar TS; Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida, Gainesville, FL, USA., Westerveld DR; Department of Medicine, University of Florida, Gainesville, FL, USA., Yang D; Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida, Gainesville, FL, USA., Draganov PV; Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida, Gainesville, FL, USA.
Jazyk:	angličtina
Zdroj:	Translational gastroenterology and hepatology [Transl Gastroenterol Hepatol] 2022 Oct 25; Vol. 7, pp. 34. Date of Electronic Publication: 2022 Oct 25 (Print Publication: 2022).
DOI:	10.21037/tgh-20-269
Abstrakt:	Background: Flexible endoscopic cricopharyngeal myotomy and septotomy offer a minimally invasive transluminal option for the treatment of symptomatic Zenker's diverticulum (ZD). There is currently no consensus regarding postoperative follow-up imaging. We suggest a standardized computed tomography (CT) esophagram protocol for radiographic evaluation of postoperative findings. Methods: Single center retrospective analysis of patients with symptomatic ZD who underwent flexible endoscopic diverticulotomy and postoperative imaging with CT esophagram from January 2015 to March 2020. An experienced radiologist blinded to the initial imaging reports prospectively interpreted all CT esophagram findings, in order to minimize bias. Results: Twenty-one patients underwent CT esophagram following flexible endoscopic diverticulotomy for ZD. Diverticulotomy was technically successful in all patients. Most common findings on imaging included: atelectasis (13/21; 62%), persistent esophageal diverticulum (7/21; 33%), pneumomediastinum (3/21; 14%), aspiration (2/21; 10%), and extraluminal air and contrast extravasation consistent with focal esophageal perforation (1/21; 5%). Conclusions: We describe a standardized, simple, and accessible CT esophagram protocol for postoperative imaging of patients with post-flexible endoscopic cricopharyngeal myotomy and septotomy for ZD. CT esophagram facilitates a definitive exclusion of focal esophageal perforation as a postoperative complication of flexible endoscopic diverticulotomy by ruling out extraluminal air and contrast extravasation. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-20-269/coif). DY reports that he is a consultant for Boston Scientific, Lumendi, and Steris, outside the submitted work; PVD reports that he is a consultant for Boston Scientific, Olympus, Cook Medical, Lumendi, and Microtech, outside the submitted work. The other authors have no conflicts of interest to declare. (2022 Translational Gastroenterology and Hepatology. All rights reserved.)
Databáze:	MEDLINE
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