Transoral Flexible Endoscopic Therapy of Zenker's Diverticulum

Law, Ryan; Baron, Todd H.

doi:10.1159/000355507

Dig Surg

2013

DOI: 10.1159/000355507

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Transoral Flexible Endoscopic Therapy of Zenker's Diverticulum

Ryan Law

Todd H. Baron

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Cited by 3 publications

(2 citation statements)

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“…2 Aspiration pneumonia and pneumonitis are associated with larger or more symptomatic diverticula, and can lead to significant morbidity and mortality. 5 Interventional management of these diverticula has made significant strides in the recent past, with a progression from surgical procedures to flexible endoscopic septotomy. 6 As a modern endoscopic technique, submucosal endoscopic tunneling techniques have become a well-recognized, minimally invasive, advanced endoscopic therapy for other conditions, including achalasia.…”

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confidence: 99%

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Per Oral Endoscopic Myotomy for Zenker’s Diverticulum

Kahaleh

Mahpour

Tyberg

et al. 2021

Journal of Clinical Gastroenterology

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Introduction: Endoscopic management of Zenker diverticuli (ZD) has traditionally been via septotomy technique. The recent development of tunneling technique has shown to be both efficacious and safe. The aim of this study is to evaluate the tunneling technique using per oral endoscopic myotomy (Z-POEM) versus septotomy.Methods: Patients who underwent endoscopic management of ZD either by Z-POEM or septotomy from March 2017 until November 2020 from 9 international academic centers were included. Demographics, clinical data preprocedure and postprocedure, procedure time, adverse events, and hospital length of stay were analyzed.Results: A total of 101 patients (mean age 74.9 y old, 55.4% male) were included: septotomy (n = 49), Z-POEM (n = 52). Preprocedure Functional Oral Intake Scale score and Eckardt score was 5.3 and 5.4 for the septotomy group and 5.9 and 5.15 for the Z-POEM group. Technical success was achieved in 98% of the Z-POEM group and 100% of the septotomy group. Clinical success was achieved in 84% and 92% in the septotomy versus Z-POEM groups. Adverse events occurred in 30.6% (n = 15) in septotomy group versus 9.6% (n = 5) in the Z-POEM group (P = 0.017). Reintervention for ongoing symptoms occurred in 7 patients in the septotomy group and 3 patients in the Z-POEM group. Mean hospital length of stay was shorter for the Z-POEM group, at 1.5 versus 1.9 days. Conclusions:A tunneling technique via the Z-POEM procedure is an efficacious and safe endoscopic treatment for ZD. Z-POEM is a safer procedure with a statistically significant reduction in adverse events compared with traditional septotomy technique.

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confidence: 99%

“…ZD can lead to aspiration events, usually secondary to pooling of food and oral secretions into the pseudodiverticulum 2. Aspiration pneumonia and pneumonitis are associated with larger or more symptomatic diverticula, and can lead to significant morbidity and mortality 5…”

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confidence: 99%

Per Oral Endoscopic Myotomy for Zenker’s Diverticulum

Kahaleh

Mahpour

Tyberg

et al. 2021

Journal of Clinical Gastroenterology

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Laser surgery for Zenker’s diverticulum: European combined study

Papaspyrou¹,

Schick²,

Papaspyrou

et al. 2015

Eur Arch Otorhinolaryngol

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Surgical intervention is the gold standard of treatment for Zenker's diverticulum. The aim of this study was to examine the role of laser surgery in a large number of patients with this pathological entity. The data of 91 consecutive patients treated due to Zenker's diverticulum with the aid of CO2 laser in three institutions (Homburg/Saar and Marburg, Germany/Athens, Greece) during the last 10 years were retrospectively analyzed. Parameters examined were sex, age, preoperative symptoms, length of operation and complications, revision surgery necessity and degree of patient satisfaction. All patients had a minimum follow-up of one year. Dysphagia was the most common preoperative symptom (78 %). The most common minor complication was dental injury (6.6 %), but a serious complication in form of emphysema was observed in only two patients (2.2 %). A surgical revision was necessary in 8 (8.8 %) of the treated patients. The majority of treated patients was free of symptoms (86.8 %), or presented mild symptoms (9.9 %) one year after intervention, and only three patients (3.3 %) were dissatisfied. Our study shows that laser treatment of Zenker's diverticulum is an efficient operative technique associated with low complications rates and significant improvement of patients' symptoms in most of the examined cases.

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Esophageal Strictures and Diverticula

Smith¹

2015

Surgical Clinics of North America

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Transoral Flexible Endoscopic Therapy of Zenker's Diverticulum

Cited by 3 publications

References 13 publications

Per Oral Endoscopic Myotomy for Zenker’s Diverticulum

Per Oral Endoscopic Myotomy for Zenker’s Diverticulum

Laser surgery for Zenker’s diverticulum: European combined study

Esophageal Strictures and Diverticula

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