xRead - Swallowing Disorders in the Adult Patient (October 2024)
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they must be summarized and categorized to illustrate key concepts, and there is possibility of misclassi fi cation bias. The database cannot ascertain nuances of the shared decision-making between patients and surgeon which can include (but not limited to) surgeon experience, surgeon training, patient comorbidity, patient prefer ences, and hospital resources. For example, this database continued to accrue (albeit slowly) during the SARS-CoV 2/COVID-19 pandemic, which could have impacted routine postoperative management of patients with ZD. Finally, this review does not include pre-operative consid erations, such as size of diverticula or comorbid condi tions which may affect endoscopic versus open, LOS, diet, and/or postoperative imaging. Future investigations will more closely examine major complications related to ZD treatment including predictors of frailty, prognostic factors, and assessments of treatment response. CONCLUSION ZD is the most common CPMD with diverticula, often affecting patients in the seventh decade of life. This study sought to evaluate trends in postoperative manage ment of patients with ZD by evaluating LOS, use of post operative esophagography, and diet recommendations. The endoscopic approach to repair was favored (80% com pared with 20% open) in this multicenter study, consis tent with prior best practice survey data. Herein, 81.2% of patients were observed for <23 h, 49% were discharged on pureed/liquid diet, and about 20% had postoperative esophagography (one third with concerned for leak, com pared to routine testing). Twenty-nine complications were identi fi ed postoperatively across 298 patients with ZD. Diet on discharge was not affected by surgical approach (endoscopic vs. open), though approach did impact LOS. If complications occurred, patients were more likely admitted for >48h with prolonged dietary restriction on discharge. Even in this scenario, npo with NGT was rare. With concern for leak, imaging was often utilized in determining next steps.
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Laryngoscope 134: June 2024
McKeon et al.: Postop Management of ZD, Contemp. Perspective 2683
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