Killian-Jamieson憩室的外科治疗：开放与内镜结局的系统评价。
Surgical Management of Killian-Jamieson Diverticulum: A Systematic Review of Open and Endoscopic Outcomes.
文献信息
| PMID | 42872753 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Muhammad Zahlaka |
| 作者单位 | Department of Otolaryngology Head and Neck Surgery, Wolfson Medical Center, Holon, Israel. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 系统评价Killian-Jamieson憩室（KJD）的外科治疗，并比较开放与内镜入路的结局，重点关注症状控制、围手术期恢复及喉返神经（RLN）并发症。
数据来源： 检索PubMed/MEDLINE、Embase、Scopus、Web of Science和Cochrane Library，自建库至2025年12月1日，并补充Google Scholar和参考文献筛选。
综述方法： 遵循PRISMA 2020，2名评价者独立筛选记录、选择研究并提取接受手术治疗的KJD患者个体数据。纳入报告描述开放经颈或内镜治疗并报告术后结局。使用Joanna Briggs Institute清单评价研究质量，并按入路对数据进行描述性综合。
结果： 共分析41项研究、86例患者，其中47例接受内镜治疗，39例接受开放手术。总体临床成功（定义为症状缓解或改善且无需再次干预）在两组中均较高，失败率为3.5%。完全缓解在开放手术后报告更常见，而内镜治疗更常获得部分改善。在有围手术期数据的患者中，内镜入路与更早经口进食和更短住院时间相关，且未报告死亡。
结论： KJD的开放手术和内镜手术均能获得良好的症状结局且并发症率低，当前证据未显示一种入路具有明确优越性。鉴于KJD的罕见性和现有病例系列样本量小，本综述提供了迄今为止关于开放与内镜技术手术结局及围手术期风险的最全面综合。
英文摘要
OBJECTIVE: To systematically review surgical management of Killian-Jamieson diverticulum (KJD) and compare outcomes of open and endoscopic approaches, focusing on symptom control, perioperative recovery, and recurrent laryngeal nerve (RLN) morbidity.
DATA SOURCES: PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were searched from inception to December 1, 2025, with additional Google Scholar and reference screening.
REVIEW METHODS: Following PRISMA 2020, 2 reviewers independently screened records, selected studies, and extracted patient-level data on surgically treated KJD. Eligible reports described open transcervical or endoscopic treatment with postoperative outcomes. Study quality was appraised with Joanna Briggs Institute checklists, and data were synthesized descriptively by approach.
RESULTS: Forty-one studies including 86 patients were analyzed, 47 treated endoscopically and 39 with open surgery. Overall clinical success, defined as symptom resolution or improvement without reintervention, was high in both groups with a failure rate of 3.5%. Complete resolution was reported more often after open surgery, whereas endoscopic treatment more frequently yielded partial improvement. In patients with perioperative data, endoscopic approaches were associated with earlier oral intake and shorter hospital stay, and no mortality was reported.
CONCLUSION: Both open and endoscopic surgery for KJD achieve favorable symptom outcomes with low complication rates, and current evidence does not show clear superiority of one approach. Given the rarity of KJD and the small size of existing series, this review provides the most comprehensive synthesis to date of surgical outcomes and perioperative risks across open and endoscopic techniques.