아르곤 플라즈마 응고법을 이용한 젠커게실 치료 1예
A Case of Zenker's Diverticulum Treated by Argon Plasma Coagulation
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초록
젠커게실은 일반적으로 크기가 작은 경우는 특별한 증상이 없고 치료도 필요 없는 경우가 대부분이다. 그러나 크기가 큰 경우는 음식물의 역류나 흡인에 의한 기침, 질식, 전경부 이물감 등이 발생할 수 있고 편편상피암의 발생 보고도 있어 치료가 필요하다. 치료 방법은 수술적 치료법과 내시경 치료법이 있으며, 내시경 치료법이 수술적 치료법에 비해서 보다 비침습적이고 합병증 발생 가능성이 낮으며 신속한 증상의 호전을 기대할 수 있다는 장점이 있어 최근에는 우선적인 치료법으로 인정되고 있다. 저자들은 지속적인 삼킴곤란 증상으로 내원한 환자에서 상부위장관내시경검사에서 젠커게실을 진단하고 아르곤 플라즈마 응고법으로 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Zenker's diverticulum occurs mainly in elderly patients with typical symptoms including dysphagia, regurgitation, chronic cough, aspiration, and weight loss. A diagnosis is easily established on upper endoscopy or barium studies. The treatment is surgery or endoscopic cricopharyngeal myotomy. Endoscopic procedures include staple assisted diverticulostomy, CO2 laser, transparent oblique-endhood attached endoscopic diverticulostomy, and argon plasma coagulation. Minimally invasive endoscopic treatments are associated with a shorter operating time, shorter postoperative hospital stay, quicker resumption of oral intake, and fewer overall complications. Argon plasma coagulation can be performed in any regular endoscopy unit and is less invasive, economical, faster, and well-tolerated. In particular, older patients in a poor general condition, at high surgical risk or with contraindications to general anesthesia can be treated with argon plasma coagulation. (Korean J Gastrointest Endosc 2006;33:159-162)
참고문헌 (19)
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