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Surgical interventions for pharyngeal pouchSen P, Lowe DA, Farnan T
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SummaryNo evidence on the best surgical procedure for a pharyngeal pouchA pharyngeal pouch is a pocket which can develop in the pharynx (throat), just above the entrance to the oesophagus (gullet). It may cause difficulty in swallowing, sensation of a lump in the throat and troublesome regurgitation of food. Food may become lodged in the pouch and this as well as regurgitation may lead to weight loss, hoarseness of voice and recurrent chest infections. A pharyngeal pouch is treated by surgery which may either be 'open' (through an incision in the neck) or 'endoscopic' (through the mouth). The review found no evidence to show which surgical method is more effective.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
July 20. 2005 AbstractBackgroundA pharyngeal pouch is an out-pouching or pocket that develops from the posterior wall of the pharynx just above the entrance to the oesophagus (gullet). Pouches may give rise to difficulty in swallowing, sensation of a lump in the throat or of food sticking in the throat and may lead to troublesome regurgitation of food. Food may enter the pouch rather than passing down the oesophagus and this and regurgitation may result in weight loss, hoarseness of voice and/or recurrent chest infections. The management of patients with a pharyngeal pouch may be either conservative or surgical. Surgical management can be further divided into two broad categories: endoscopic and open procedures. In the first half of the twentieth century an open surgical approach to the pouch was most frequently used, and remains common in some parts of the world. In recent decades endoscopic procedures (where the approach is made through the mouth) have become popular. The superiority of one approach over another has yet to be clearly demonstrated. ObjectivesTo assess the effectiveness and safety of open and endoscopic surgical procedures for the management of a pharyngeal pouch. Search strategyWe searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Medline; EMBASE; CINAHL; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 22 September 2008. Selection criteriaWe sought to identify all randomised controlled trials (RCTs) comparing two or more interventions. Data collection and analysisThree authors assessed the eligibility of trials for inclusion in the review, based on pre-determined criteria. Main resultsNo trials were identified which fulfilled the criteria. Authors' conclusionsThere is no evidence from high quality randomised controlled trials to demonstrate the effectiveness of endoscopic compared with open procedures for pharyngeal pouch. There is no good evidence to establish whether one endoscopic procedure is superior to another.
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