Treatment of Zenker's diverticulum through a flexible endoscope with a transparent oblique-end hood attached to the tip and a monopolar forceps.

Abstract:

BACKGROUND AND STUDY AIMS:Zenker's diverticulum was commonly treated by means of external transcervical diverticulectomy, myotomy or diverticulopexy, or by means of an endoscopic myotomy through a rigid endoscope. Gastroenterologists first described flexible endoscopic therapy for Zenker's diverticulum in 1995. In our single-center study we report the safety and feasibility of endoscopic myotomy through a flexible endoscope, performed at a secondary referral centre. PATIENTS AND METHODS:A series of 21 patients with Zenker's diverticulum were treated using a flexible endoscope with a transparent oblique-end hood attached to the tip and a monopolar coagulation forceps. Relief of the dysphagia was the main outcome measure with evaluation of safety and complications. Dysphagia was graded on a scale of 0 to 4 before and after treatment. General anesthesia was not used. RESULTS:Access to the esophagus was attained without problems in all patients. Oral feeding was resumed the following day. Complete relief of dysphagia was reported by all patients after 1 month. Dysphagia recurred in two patients (9.5%) after the first session. These patients were successfully treated again in the same way. Adverse events were limited to transient cervical emphysema in a single patient. CONCLUSIONS:This endoscopic technique is an efficient, safe and minimally invasive method for the treatment of Zenker's diverticulum. General anesthesia is not necessary and oral feeding can be resumed the next day. In view of the excellent results and minimal complications, it can be considered a safe alternative for the treatment of Zenker's diverticulum.

journal_name

Endoscopy

journal_title

Endoscopy

authors

Christiaens P,De Roock W,Van Olmen A,Moons V,D'Haens G

doi

10.1055/s-2006-945118

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

137-40

issue

2

eissn

0013-726X

issn

1438-8812

journal_volume

39

pub_type

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