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Canete-Gomez J.,Hospitales Universitarios Virgen del Rocio | Ramirez-Plaza C.P.,Hospitales Universitarios Virgen del Rocio | Lopez Rueda B.,Hospital Regional Universitario Of Malaga Carlos Haya | Ibanez-Delgado F.,Hospitales Universitarios Virgen del Rocio | And 3 more authors.
Cirugia Espanola | Year: 2012

Introduction: The classic treatment of Zenker's diverticulum (ZD) has been cricopharyngeal myotomy (CPM), with the need or not to resect it being argued (diverticulectomy versus diverticulopexy). However, the advance of endoscopic techniques requires new treatment strategies to be established. We analyse the complications and clinical results of our series with cricopharyngeal myotomy and diverticulectomy in patients with ZD. Method: A retrospective, observational and descriptive study was conducted on 33 patients who, between January 1998 and December 2010, had a diverticulectomy and CPM performed in the university hospitals Virgen del Rocío in Seville and Carlos Haya in Malaga. Demographic and operative variables that might be associated with morbidity were analyzed. Results: Seventeen patients were treated in the Carlos Haya Hospital, Málaga and sixteen in the Virgen del Rocío Hospital, Seville. Although there were no deaths, the morbidity rate of the series was 27% (9 cases), all associated with an oesophageal-cutaneous fistula. None of the variables studied were significantly associated with the appearance of morbidity. None of the patients had a clinical or radiological recurrence of ZD after a mean follow up of 44 months (range, 6 -192). Conclusions: Diverticulectomy combined with CPM is a good technique for the treatment of ZD, with excellent clinical and functional results in the medium to long term, despite the high morbidity in the form of an oesophageal-cutaneous fistula. © 2011 AEC.

Ramirez-Plaza C.P.,Hospital Regional Universitario Of Malaga Carlos Haya | Rodriguez-Canete A.,Hospital Regional Universitario Of Malaga Carlos Haya | Dominguez-Lopez M.E.,Hospital Regional Universitario Of Malaga Carlos Haya | Valle-Carbajo M.,Hospital Regional Universitario Of Malaga Carlos Haya | And 4 more authors.
Endocrinologia y Nutricion | Year: 2010

Background: After the first reports in 1992, laparoscopic adrenalectomy (LA) has evolved technically until becoming the standard approach for the treatment of most of the adrenal gland diseases. Material y methods: Retrospective and descriptive study of 67 patients who underwent 68 LA between January-1998 and December-2008 in the Laparoscopic Surgery Unit of the General and Digestive Surgery Service in a third level hospital (only one case of bilateral LA). The group was divided in 2 periods, P-1 (1998-2003, 22 cases) and P-2 (2004-2008, 45 cases), which have been compared to evaluate the evolution of the LA technique. Results: Indications for LA were: 19 incidentalomas, 19 primary hyperaldosteronism, 18 pheocromocitoms, 5 cases of symptomatic and non-functioning adrenal masses, 4 Cushing adenomas and 2 metastases. There was no mortality, only 4 patients had minor complications (6%) and conversion rate was only 3% (2 cases). Mean size of adrenal glands resected was 3,83 cm and the mean operative time was 86 minutes. Mean postoperative hospital stay was 3 days and in P-2 seventeen patients were discharged on an outpatient basis (hospital stay less than 23 hours). Conclusions: in our experience, LA for the treatment of adrenal diseases has shown to be safe, effective and reproducible with low complications and excellent tolerance by patients. When the learning curve is overcome, hospital stay and operative time clearly decrease. As a consequence, LA can be planned in selected cases as outpatient surgery with good results. © 2010 Sociedad Española de Endocrinología y Nutrición.

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