Flexible Endoscopic Treatment for Zenker’s Diverticulum – Experience on 31 Patients

Pop, Anamaria; Tanțău, Alina; Tefas, Cristian; Groza, A; Tanţău, Marcel

doi:10.15403/jgld.2014.1121.273.zen

Cited by 4 publications

(5 citation statements)

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“…The American Society of Anesthesiologists score was highest in the Z-POEM group, followed by the flexible then rigid endoscopic septotomy groups (2.45 [SD 0.69], 2.32 [SD 0.71], and 2.15 [SD 0.69], respectively; P = 0.05). The mean size of the diverticulum was smallest in the flexible endoscopic septotomy group, followed by Z-POEM and rigid endoscopic septotomy groups (28.65 [SD 12.33] mm, 34.85 [SD 14.68], and 36.47 [SD 16.73] mm, respectively; P = 0.003).…”

Section: Resultsmentioning

confidence: 96%

“…The analysis was performed using SPSS software (SPSS 16.0, Chicago, Illinois, USA). 16.73] mm, respectively; P = 0.003).…”

Section: Discussionmentioning

confidence: 91%

“…Electronic records were reviewed to capture the following variables: demographics, diverticulum size (determined either endoscopically or radiographically), dysphagia score, other symptoms (aspiration, choking, halitosis, regurgitation, weight loss, and others), imaging findings, prior surgical or endoscopic interventions, procedure time, clinical success, technical success, type of anesthesia, length of hospital stay, symptom recurrence at follow-up, adverse events with severity graded according to the American Society for Gastrointestinal Endoscopy (ASGE) lexicon [15], and duration of follow-up. The authors acknowledge that 43 patients from this study have been included in previous publications [10,16,17]; however, no analysis comparing the three procedures has been performed previously. and Bennett dysphagia score to ≤ 1), clinical failure, and clinical recurrence.…”

Section: Methodsmentioning

confidence: 99%

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Zenker’s peroral endoscopic myotomy, or flexible or rigid septotomy for Zenker’s diverticulum: a multicenter retrospective comparison

et al. 2021

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Background Treatment of Zenker’s diverticulum has evolved from open surgery to endoscopic techniques, including flexible and rigid endoscopic septotomy, and more recently, peroral endoscopic myotomy (Z-POEM). This study compared the effectiveness of flexible and rigid endoscopic septotomy with that of Z-POEM. Methods Consecutive patients who underwent endoscopic septotomy (flexible/rigid) or Z-POEM for Zenker’s diverticulum between 1/2016 and 9/2019 were included. Primary outcomes were clinical success (decrease in Dakkak and Bennett dysphagia score to ≤ 1), clinical failure, and clinical recurrence. Secondary outcomes included technical success and rate/severity of adverse events. Results 245 patients (110 females, mean age 72.63 years, standard deviation [SD] 12.37 years) from 12 centers were included. Z-POEM was the most common management modality (n = 119), followed by flexible (n = 86) and rigid (n = 40) endoscopic septotomy. Clinical success was 92.7 % for Z-POEM, 89.2 % for rigid septotomy, and 86.7 % for flexible septotomy (P = 0.26). Symptoms recurred in 24 patients (15 Z-POEM during a mean follow-up of 282.04 [SD 300.48] days, 6 flexible, 3 rigid [P = 0.47]). Adverse events occurred in 30.0 % rigid septotomy patients, 16.8 % Z-POEM patients, and 2.3 % flexible septotomy patients (P < 0.05). Conclusions There was no difference in outcomes between the three treatment approaches for symptomatic Zenker’s diverticulum. Rigid endoscopic septotomy was associated with the highest rate of complications, while flexible endoscopic septotomy appeared to be the safest. Recurrence following Z-POEM was similar to flexible and rigid endoscopic septotomy. Prospective studies with long-term follow-up are required.

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Section: Resultsmentioning

confidence: 96%

“…The analysis was performed using SPSS software (SPSS 16.0, Chicago, Illinois, USA). 16.73] mm, respectively; P = 0.003).…”

Section: Discussionmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 99%

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Zenker’s peroral endoscopic myotomy, or flexible or rigid septotomy for Zenker’s diverticulum: a multicenter retrospective comparison

et al. 2021

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“…This is a minimally invasive approach with a high success rate (91%) [ 3 ]. However, the rates of symptom recurrence and adverse events are quite high (11.3% and 11.0%, respectively) because the bottom of the diverticulum cannot be clearly identified, leading to incomplete division of the septal muscle [ [3] , [4] , [5] ]. In contrast, Z-POEM allows for clearer identification of the septal muscle, leading to complete septal division.…”

Section: Discussionmentioning

confidence: 99%

Successful advanced third-space endoscopic surgery by per-oral endoscopic myotomy (Z-POEM) for Zenker’s diverticulum: A case report and review of literature

Krutsri

Phalanusitthepha

Hiranyatheb

et al. 2020

International Journal of Surgery Case Reports

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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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Flexible Endoscopic Treatment for Zenker’s Diverticulum – Experience on 31 Patients

Abstract: Endoscopic management for ZD was efficient and safe in our series of patients. A short hospitalization period was required.

Cited by 4 publications

References 25 publications

Zenker’s peroral endoscopic myotomy, or flexible or rigid septotomy for Zenker’s diverticulum: a multicenter retrospective comparison

Zenker’s peroral endoscopic myotomy, or flexible or rigid septotomy for Zenker’s diverticulum: a multicenter retrospective comparison

Successful advanced third-space endoscopic surgery by per-oral endoscopic myotomy (Z-POEM) for Zenker’s diverticulum: A case report and review of literature

Zenker's Diverticle Endoscopic Treatment or Open Technique?

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