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Mettias B, Uddin J. Tips for improving access in endoscopic stapling of pharyngeal pouch. BMJ Case Rep 2020; 13:13/11/e235201. [PMID: 33257352 DOI: 10.1136/bcr-2020-235201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Endoscopic stapling is the preferred technique for treatment of symptomatic pharyngeal pouches. The use of stapling with a standard pharyngoscope can be successful in difficult access patients. This modification of the technique can prevent the conversion of an endoscopic approach to an open approach.
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Affiliation(s)
| | - Javed Uddin
- ENT, Leicester Royal Infirmary, Leicester, UK
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Hampton T, Allan J, Pearson D, Emerson H, Jones GH, Junaid M, Kanzara T, Lau AS, Siau R, Williams SP, Wilkie MD. A multi-centre analysis of a decade of endoscopic pharyngeal pouch surgery in Cheshire and Merseyside. J Laryngol Otol 2020; 134:1-6. [PMID: 33138870 DOI: 10.1017/s0022215120002224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There are sparse data on the outcomes of endoscopic stapling of pharyngeal pouches. The Mersey ENT Trainee Collaborative compared regional practice against published benchmarks. METHODS A 10-year retrospective analysis of endoscopic pharyngeal pouch surgery was conducted and practice was assessed against eight standards. Comparisons were made between results from the tertiary centre and other sites. RESULTS A total of 225 procedures were performed (range of 1.2-9.2 cases per centre per year). All centres achieved 90 per cent resumption of oral intake within 2 days. All centres achieved less than 2-day hospital stays. Primary success (84 per cent (i.e. abandonment of endoscopic stapling in 16 per cent)), symptom resolution (83 per cent) and recurrence rates (13 per cent) failed to meet the standard across the non-tertiary centres. CONCLUSION Endoscopic pharyngeal pouch stapling is a procedure with a low mortality and brief in-patient stay. There was significant variance in outcomes across the region. This raises the question of whether this service should become centralised and the preserve of either tertiary centres or sub-specialist practitioners.
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Affiliation(s)
- T Hampton
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Liverpool University Hospitals NHS Foundation Trust, UK
| | - J Allan
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Wirral University Teaching Hospital NHS Foundation Trust, Birkenhead, UK
| | - D Pearson
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Wirral University Teaching Hospital NHS Foundation Trust, Birkenhead, UK
| | - H Emerson
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, UK
| | - G H Jones
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Liverpool University Hospitals NHS Foundation Trust, UK
| | - M Junaid
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, UK
| | - T Kanzara
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Mid Cheshire Hospitals NHS Trust, Crewe, UK
| | - A S Lau
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Wirral University Teaching Hospital NHS Foundation Trust, Birkenhead, UK
| | - R Siau
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Liverpool University Hospitals NHS Foundation Trust, UK
| | - S P Williams
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Countess of Chester Hospital NHS Foundation Trust, Chester, UK
| | - M D Wilkie
- Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK
- Department of ENT Surgery, Liverpool University Hospitals NHS Foundation Trust, UK
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