{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:08:29Z","timestamp":1740107309742,"version":"3.37.3"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Surgery is the only effective treatment strategy for a symptomatic pharyngeal pouch. However, octo\u2010 and nonagenarians are often denied referral to a surgeon because of perceived increased risks. Here, we compare the outcomes of pharyngeal pouch surgery in octo\u2010 and nonagenarians with patients under 80 years\u2010of\u2010age and determine the factors which predict post\u2010operative complications and improvement in swallowing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analysis of a prospectively maintained database of patients who underwent pharyngeal pouch surgery across seven hospitals over 15 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 113 patients (\u226580 years\u2010of\u2010age: 27, &lt;80 years\u2010of\u2010age: 86) underwent endoscopic or open pharyngeal pouch surgery. Despite more comorbidities and a longer hospital stay (median: one extra day), patients\u2009\u226580 years\u2010of\u2010age had comparable operative time, complication profile, intensive care admission, emergency reoperation, and revisional pouch surgery as their younger counterparts. Furthermore, the severity of complications was not significantly different between the two age cohorts. No surgical mortality was recorded. Multivariate analysis demonstrated that diverticulectomy combined with cricopharyngeal myotomy independently predicted higher rates of complications (OR: 4.53, 95% CI: 1.43\u201314.33, <jats:italic>p<\/jats:italic>\u2009=\u20090.010), but also greater symptomatic improvement (OR: 4.36, 95% CI: 1.50\u201312.67, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). Importantly, a greater proportion of octo\u2010 and nonagenarians experienced improved swallowing than patients\u2009&lt;80 years\u2010of\u2010age (96.3% vs. 74.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.013). Moreover, advanced age was not predictive of post\u2010operative complications on multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pharyngeal pouch surgery in octo\u2010 and nonagenarians is safe and effective. Surgical correction in this age group alleviates symptoms and improves quality\u2010of\u2010life for most patients. These patients should not be denied surgery on the basis of advanced age alone.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-021-05999-4","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T00:13:05Z","timestamp":1613779985000},"page":"1819-1827","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharyngeal Pouch Surgery in Octo\u2010 and Nonagenarians is Safe and Effective: A Multicentre Comparative Cohort Study"],"prefix":"10.1002","volume":"45","author":[{"given":"Mohamed","family":"Afzal","sequence":"first","affiliation":[{"name":"Oesophagogastric Surgery Unit Flinders Medical Centre Flinders Drive 5042 Bedford Park SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8936-4123","authenticated-orcid":false,"given":"David S.","family":"Liu","sequence":"additional","affiliation":[{"name":"Oesophagogastric Surgery Unit Flinders Medical Centre Flinders Drive 5042 Bedford Park SA Australia"},{"name":"Department of Surgery Austin Hospital 3084 Heidelberg VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Bright","sequence":"additional","affiliation":[{"name":"Oesophagogastric Surgery Unit Flinders Medical Centre Flinders Drive 5042 Bedford Park SA Australia"},{"name":"Discipline of Surgery, College of Medicine and Public Health Flinders University 5042 Bedford Park SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David I.","family":"Watson","sequence":"additional","affiliation":[{"name":"Oesophagogastric Surgery Unit Flinders Medical Centre Flinders Drive 5042 Bedford Park SA Australia"},{"name":"Discipline of Surgery, College of Medicine and Public Health Flinders University 5042 Bedford Park SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter G.","family":"Devitt","sequence":"additional","affiliation":[{"name":"Department of Surgery, Royal Adelaide Hospital University of Adelaide 5000 Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah K.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Oesophagogastric Surgery Unit Flinders Medical Centre Flinders Drive 5042 Bedford Park SA Australia"},{"name":"Discipline of Surgery, College of Medicine and Public Health Flinders University 5042 Bedford Park SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.77.910.506"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003\u20104975(98)00502\u20105"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010199906000\u201000003"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445\u20102197.2003.02909.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.08.026"},{"key":"e_1_2_8_7_1","first-page":"397","article-title":"Surgical treatment of a severe, massive, symptomatic Zenker's diverticulum in a very elderly patient","volume":"59","author":"Carlini M","year":"2007","journal-title":"Chir Italiana"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.05.036"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010557"},{"key":"e_1_2_8_10_1","unstructured":"American College of SurgeonsNational Surgical Quality Improvement Program Surgical Risk Calculator. (2020) [Cited 12 November 2020]. Available from:https:\/\/riskcalculator.facs.org\/RiskCalculator\/"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.07.063"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010019\u201009994\u20109"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010014\u20103267\u20100"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819839991"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000351433"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010200403000\u201000025"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-021-05999-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-021-05999-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-021-05999-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-021-05999-4","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,7]],"date-time":"2024-01-07T16:25:01Z","timestamp":1704644701000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-021-05999-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,19]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1007\/s00268-021-05999-4"],"URL":"https:\/\/doi.org\/10.1007\/s00268-021-05999-4","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"type":"print","value":"0364-2313"},{"type":"electronic","value":"1432-2323"}],"subject":[],"published":{"date-parts":[[2021,2,19]]},"assertion":[{"value":"30 January 2021","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2021","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The author declares that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This study was approved by the South Adelaide Local Health Network Human Research Ethics Committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was waived by the Human Research Ethics Committee for this project.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}