881 Long and Short-Term Results of Endoscopic Management of Zenker's Diverticulum

2011 ◽  
Vol 73 (4) ◽  
pp. AB157 ◽  
Author(s):  
Isaac Raijman ◽  
Dang Nguyen ◽  
Shail Maheshwari ◽  
Douglas S. Fishman
Keyword(s):  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Short Term ◽  
Zenker's Diverticulum

scholarly journals Experience and Technique for Zenker's Diverticulum Per Oral Endoscopic Myotomy: Z-POEM

2020 ◽  
Author(s):  
Eitan Podgaetz ◽  
Vani Konda
Keyword(s):  
Third Space ◽  
Zenker’S Diverticulum ◽  
Complication Rates ◽  
Short Term ◽  
Zenker's Diverticulum ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Invasive Techniques ◽  
Per Oral

Abstract Objective With the advent of minimally invasive surgery, incisionless surgery, and third-space endoscopy, the treatment for Zenker's diverticulum has also moved toward less invasive techniques Methods New incisionless per oral techniques can be applied for cricopharyngeal myotomy in Zenker's diverticulum. Results Five patients underwent Zenker's diverticulum per oral endoscopic myotomy (Z-POEM) without complications, minimal discomfort, and narcotic consumption, with complete resolution of their symptoms by history and Eckardt scores. Conclusions Z-POEM is performed entirely endoscopically with very little associated pain or complication rates, with short-term follow-up having excellent functional and symptomatic results.

scholarly journals Flexible endoscopic management of Zenker’s diverticulum

VideoGIE ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. 43-44 ◽  
Author(s):  
Chaitanya Allamneni ◽  
William Ergen ◽  
Stewart Herndon ◽  
Frederick Weber ◽  
Kondal Kyanam Kabir Baig
Keyword(s):  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Zenker's Diverticulum

Endoscopic Management of Zenker's Diverticulum: A Gastroenterologist Approach

2004 ◽  
Vol 59 (5) ◽  
pp. P239
Author(s):  
Isaac Raijman ◽  
Susan Escalante ◽  
Claudio Navarrete
Keyword(s):  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Zenker's Diverticulum

Endoscopic management of Zenker's diverticulum: Stapler assisted versus Harmonic Ace

2009 ◽  
Vol 119 (10) ◽  
pp. 1906-1912 ◽  
Author(s):  
Dawn B. Sharp ◽  
John R. Newman ◽  
J. Scott Magnuson
Keyword(s):  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Zenker's Diverticulum ◽  
Harmonic Ace

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

2018 ◽  
Vol 27 (3) ◽  
pp. 227-231
Author(s):  
Anamaria Pop ◽  
Alina Tantau ◽  
Cristian Tefas ◽  
Andrei Groza ◽  
Marcel Tantau
Keyword(s):  
Endoscopic Treatment ◽  
Symptomatic Relief ◽  
Symptom Relief ◽  
Invasive Procedure ◽  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Upper Gastrointestinal Endoscopy ◽  
Oral Contrast ◽  
Zenker's Diverticulum ◽  
Hospitalization Period

Background & Aims: The aim of this study is to present the experience of our center over the last 8 years in a series of patients with Zenker’s diverticulum (ZD), treated using an endoscopic, minimally invasive procedure. Methods: We retrospectively included 31 patients with a previously established diagnosis of ZD based on endoscopic and oral contrast examinations. Patients’ age, comorbidities, size of the diverticulum or previous endoscopic treatment were not considered exclusion criteria. A soft, flexible diverticuloscope to expose the septum and a dual knife for “cutting” the diverticular septum were used. We analyzed the short term efficacy based on symptomatic relief and occurrence of side effects, and long term efficiency at 6 and 12 months by clinical assessment, upper gastrointestinal endoscopy and oral contrast media passage. Results: Patients had a mean age of 67 years (range 42-86); 55% of them were male. All patients reported symptom relief after the procedure. A decrease of more than 70% from the initial size of the diverticulum was noted. There were 3 cases (9.67%) of intraprocedural hemorrhage, endoscopically managed. No serious post-procedural complications and no mortality were reported. The mean procedural time was 21.87 minutes (range 15-25 minutes). Average hospitalization was 2.5 days. Five patients developed recurrence and needed a second session of endoscopic treatment for achieving complete myotomy. Conclusions: Endoscopic management for ZD was efficient and safe in our series of patients. A short hospitalization period was required.

scholarly journals Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in India

2020 ◽  
Vol 11 (03) ◽  
pp. 209-214
Author(s):  
Pankaj N. Desai ◽  
Mayank V. Kabrawala ◽  
Chintan N. Patel ◽  
Rajiv M. Mehta ◽  
Subhash K. Nandwani ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Efficacy And Safety ◽  
Technical Success Rate ◽  
Dysphagia Score ◽  
Zenker's Diverticulum ◽  
Endoscopic Myotomy ◽  
The Mean

Abstract Background This study was aimed to evaluate efficacy and safety of Z–peroral endoscopic myotomy (Z-POEM; submucosal tunneling endoscopic myotomy) for Zenker’s diverticulum (ZD). Methods This is a retrospective study at a single tertiary care center in India. The Z-POEM technique was performed using principles of submucosal tunneling endoscopy with prior experience from POEM technique for achalasia cardia Results Sixteen patients (male, 62.5%; mean age, 73.2 ± 5.2 years) were included with a mean Charleson’s comorbidity index of 4.32. The mean size of ZD was 34.8 ± 10.0 mm. The technical success rate was 100%. Clinical success was achieved in 100% (16/16) with a decrease in mean dysphagia score from 2.9 to 0.2 (p <0.0001). The mean procedure time was 47 ± 7.9 minutes and mean length of septotomy was 31.9 ± 9.4 mm. The mean length of hospital stay was 1.2 ± 0.4 days. No major adverse events were noted. Capnomediastinum was noted in two cases on follow-up Gastrografin study after 24 hours (12.5%). This did not merit any treatment. One patient had intraprocedural bleed which was controlled easily. At the 18-month follow-up, two (12.5%) patients reported dysphagia recurrence (Dakkak and Bennett score 1) but did not require repeat intervention. Conclusion Endoscopic management of ZD using the POEM technique is a promising technique with improved efficacy and safety. However, long-term follow-up is needed to ensure the durability of response.

Transoral Laser-Assisted Diverticulectomy: Swallow Study Results after Complete Endoscopic Pouch Excision for Zenker’s Diverticulum

2021 ◽  
pp. 000348942110125
Author(s):  
Ryan A. McMillan ◽  
Andrew J. Bowen ◽  
Michael L. Wells ◽  
Dale C. Ekbom
Keyword(s):  
Zenker’S Diverticulum ◽  
Complication Rates ◽  
Short Term ◽  
Recurrence Rates ◽  
Zenker's Diverticulum ◽  
Pouch Size ◽  
Study Results ◽  
Significant Difference ◽  
Pouch Excision ◽  
Subjective Outcomes

Objective: Transoral endoscopic laser-assisted diverticulotomy (TELD) with diverticulectomy and diverticuloplasty (TELD + DD) for the management of Zenker’s diverticulum (ZD) has been utilized by our institution since 2016 in attempts to reduce residual pouch size. This technique involves complete endoscopic pouch excision with partial advancement of mucosal flaps. Our study compares the subjective outcomes, objective outcomes, and complication rates between TELD and TELD + DD. Methods: A retrospective cohort study was performed on patients who underwent TELD or TELD + DD by a single surgeon at a tertiary academic center (2013-2019). Videofluoroscopic swallow studies (VFSS) with esophagram, Eating Assessment Tool (EAT-10), Reflux Symptom Index (RSI), and Functional Outcome Swallowing Scale (FOSS) were collected at preoperative and 3 month follow-up visits. A single blinded reviewer recorded height, width, and depth of pre and postoperative pouches with volumetric analysis performed assuming an ellipsoid shape. Comorbidities, complications, postoperative course, and recurrence were recorded. Results: Of the 75 patients that met criteria, 27 underwent TELD + DD and 48 underwent TELD. Eighteen TELD + DD and 37 TELD had both pre and post-operative VFSS. TELD + DD and TELD had a 96 ± 7% and 87 ± 16% reduction in pouch volume, respectively ( t-test; P = .01). Complications (TELD + DD 7%, TELD 17%, fisher’s exact; P = .31) and final subjective outcomes after adjusting for initial were not significantly different between methods (EAT-10 with TELD + DD ∆ + 1.3, P = .18; RSI ∆ + 1.4, P = .29; FOSS ∆-0.02, P = .91). One short-term recurrence was reported with TELD. Conclusion: Use of TELD + DD is associated with a statistically significantly decreased residual pouch size with no significant difference in short-term subjective outcomes. Complication rates and short-term recurrence rates are comparable. Long-term recurrence rates will require further studies to characterize. Level of Evidence: Level 3.

Open Diverticulectomy and Cricopharyngotomy for Symptomatic Zenker's Diverticulum after Endoscopic Diverticuloesophagostomy

2019 ◽  
Vol 85 (3) ◽  
pp. 284-287
Author(s):  
Takuya Ogami ◽  
Joel Richter ◽  
John Jacobs ◽  
Vic Velanovich
Keyword(s):  
Surgical Resection ◽  
Medical Records ◽  
Operative Time ◽  
Symptomatic Improvement ◽  
Zenker’S Diverticulum ◽  
Open Resection ◽  
Short Term ◽  
Zenker's Diverticulum ◽  
Persistent Symptoms ◽  
The Mean

Two of the accepted treatments for symptomatic Zenker's diverticula are open resection of the diverticulum with cricopharyngotomy and transoral, endoscopic diverticuloesophagostomy with cricopharyngotomy. We report our experience with open surgical resection of the diverticulum with repeat cricopharyngotomy in patients with persistent symptoms after endoscopic diverticuloesophagostomy. This is a retrospective review of patients who underwent open surgical resection of the diverticulum, with repeat cricopharyngotomy in patients with persistent symptoms after endoscopic diverticuloesophagostomy. Medical records were reviewed for demographics, surgical detail, short-term complications, and symptomatic outcomes. Four patients underwent open resection of a Zenker's diverticulum with repeat cricopharyngotomy. There were two men and two women, with a mean age of 77.5 years. The mean operative time was 56 minutes and median length of stay was two days. All patients had improvement in dysphagia. Surgical diverticulectomy with cricopharyngotomy after failed endoscopic diverticuloesophagostomy is a technically challenging operation. However, symptomatic improvement can be achieved.

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