Evolving flexible endoscopic treatment of Zenker’s diverticulum

Sakai, Paulo

doi:10.1016/j.gie.2018.11.008

Cited by 8 publications

(15 citation statements)

References 7 publications

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“…Both approaches are thought to have similar morbidity and mortality, but a higher incidence of recurrence has been consistently observed with the endoscopic approach . In recent years, endoscopic treatment has evolved substantially, going in several directions in operative technique …”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and Management of Zenker Diverticulum in a Low-Threshold Single-payer Health Care System

Uoti

Andersson

Robinson

et al. 2022

JAMA Otolaryngol Head Neck Surg

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OBJECTIVETo describe the population-wide incidence of Zenker diverticulum over a 20-year period and characterize management strategies across specialties and treatment settings. DESIGN, SETTING, AND PARTICIPANTSThis retrospective national cohort study was conducted from January 1, 1996, through December 31, 2015, and reviewed patient records from the Care Register for Healthcare in Finland, from which patients with Zenker diverticulum were identified. The data were analyzed in October 2021. EXPOSURES Zenker diverticulum. MAIN OUTCOME AND MEASURE The incidence of Zenker diverticulum per 100 000 person-years. RESULTS A total of 2736 patients (median [IQR] age at diagnosis 72.0 [19-106] years; 1278 women [46.7%]) were identified, making the annual incidence of Zenker diverticulum in Finland 2.9/100 000 person-years. Men had higher incidence (3.7/100 000 person-years) compared with women (2.3/100 000 person-years), with an incidence rate ratio of 1.61 (95% CI, 1.48-1.76; P < .001). Within the study population, 1044 patients (38.2%) underwent surgical treatment and 227 (8.3%) underwent 2 or more surgeries. The choice of initial operative approach depended on the medical specialty (Cramer V = 0.41) and on specific catchment area (Cramer V = 0.41). Overall, endoscopic approaches for initial operations were most popular. CONCLUSIONS AND RELEVANCEThe cohort study results found that the incidence of Zenker diverticulum was 2.9/100 000 person-years. Most patients with Zenker diverticulum did not undergo definitive therapy. Some hospital districts and some medical specialties were more likely to opt for conservative treatment than others. The choice of operative approach depended more on physician-level factors rather than patient profiles.

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Section: Introductionmentioning

confidence: 99%

“…[16][17][18] In recent years, endoscopic treatment has evolved substantially, going in several directions in operative technique. 19,20 The epidemiology of ZD is largely unknown. Past studies have generally included patients from a single center and sometimes a single surgeon or division.…”

mentioning

confidence: 99%

Epidemiology and Management of Zenker Diverticulum in a Low-Threshold Single-payer Health Care System

Uoti

Andersson

Robinson

et al. 2022

JAMA Otolaryngol Head Neck Surg

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“…9 They provide short hospitalization time, high functional recovery, and low complication rates. 3,4,[10][11][12] However, surgical treatment (TD) remains as an alternative in centers without equipment and experience in transoral treatment methods. Surgery is still at the forefront in patients with large symptomatic diverticulum, as well.…”

Section: Discussionmentioning

confidence: 99%

Zenker's Diverticulum: 20 Years of Experience and Outcomes of Surgical Resection

Uludağ¹,

Şanlı²,

Gures³

et al. 2021

Turkiye Klinikleri J Med Sci

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Zenker's diverticulum (ZD) is an esophageal pseudodiverticulum formed by cricopharyngeal muscle dysfunction leading to outpouching of mucosa and submucosa from the Killian triangle. 1 It's wall is thin and fragile because it does not contain a muscle layer. Symptomatic disease is usually seen in the elderly population and the main symptom of the disease is dysphagia. 1,2 In recent years, traditional

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“…The patients were between 42 and 86 years old; 55% of them were men. Complications were minimal and during the procedure, the mean time was relatively short and recurrence only occurred in 5 patients, requiring a second session of endoscopic treatment to achieve a complete myotomy [16,17].…”

Section: Fig-2: Zenker's Diverticulummentioning

confidence: 99%

Zenker's Diverticle Endoscopic Treatment or Open Technique?

2021

Cross Current Int J Med Biosci

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Introduction: Zenker's diverticulum is a protrusion of the pharyngeal mucosa through Killian's triangle. It is a rare pathology, but of great importance since it compromises the quality of life of patients who suffer from it. In addition, it can be treated by different methods which have been evolving over the years, but at the moment applying them to each patient, each one has its own advantages and disadvantages, so these should be evaluated with caution, individually according to each case requires it. Materials and methods: A narrative review was carried out, using databases such as Scielo, PubMed, Sciencedirect, academic google. A search for articles in indexed journals in English and Spanish was carried out from 2010 to 2021. Results: In the management of Zenker's diverticulum there are several methods, endoscopic approach and open technique, currently the endoscopic approach is preferred over the external one. Although the open technique has been more studied and the endoscopic one represents a challenge that requires the expertise of the professional who performs it, surgeons prefer endoscopic techniques since they are minimally invasive and are believed to cause fewer complications. Also, they produce results similar to classic transcervical repair. Conclusion: The open technique is a more definitive and immediate method that relieves symptoms and prevents recurrence. The endoscopy technique is shorter, it avoids recurrence, but the results are highly variable in each patient.

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Evolving flexible endoscopic treatment of Zenker’s diverticulum

Cited by 8 publications

References 7 publications

Epidemiology and Management of Zenker Diverticulum in a Low-Threshold Single-payer Health Care System

Epidemiology and Management of Zenker Diverticulum in a Low-Threshold Single-payer Health Care System

Zenker's Diverticulum: 20 Years of Experience and Outcomes of Surgical Resection

Zenker's Diverticle Endoscopic Treatment or Open Technique?

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