Flexible Endoscopic Treatment of Zenker's Diverticulum: a New Approach

Mulder, Chris J.; Hartog, G. den; Robijn, R. J.; Thies, J. E.

doi:10.1055/s-2007-1005737

Cited by 160 publications

(58 citation statements)

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“…We identified 6,915 patients from 93 studies evaluating the effect of the surgical treatment for ZD, including 52 studies [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59] (n = 3,336) on endoscopic surgeries, 22 [60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81] (n = 2,204) on open surgeries, and 19 [3,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,…”

Section: Search Resultsmentioning

confidence: 99%

“…Flexible endoscopic diverticulotomy was not reported until 1995 [53,54], which can be performed under conscious sedation without general anesthesia and neck extension - the two major advantages over the rigid endoscopic approach. Using a variety of accessories (nasogastric tube, hood, endoscopic cap, and overtube), the septum between the diverticulum and esophageal lumen can be successfully visualized and stabilized without overextension of the neck.…”

Section: Flexible Endoscopic Diverticulotomymentioning

confidence: 99%

“…Some authors prefer multiple sessions in order to avoid perforation and mediastinitis. The mean number of treatment sessions varied from 1 to 3 in different studies [9,13], and usually the operation can be repeated easily at an interval of 1 day to several weeks [13,53,54]. From our literature search, there were 472 patients from 12 studies undergoing flexible endoscopic diverticulotomy (table 1B).…”

Section: Flexible Endoscopic Diverticulotomymentioning

confidence: 99%

“…Only 1 patient with the endoscopic stapling procedure developed recurrence in the mean 20-month follow-up period. In 1995, Mulder et al [53] were the first to describe flexible endoscopic diverticulostomy in 20 ZD patients using monopolar biopsy forceps. A good symptomatic response was seen after a mean of three treatment sessions and there were no major complications.…”

Section: Flexible Endoscopic Diverticulotomymentioning

confidence: 99%

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Surgical Treatment of Zenker's Diverticulum

Yao¹,

Zhao²,

Hu³

et al. 2013

Dig Surg

151

152

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Background: Different surgical techniques have been indicated for the management of Zenker's diverticulum (ZD), including diverticulectomy, diverticulopexy, and diverticular inversion, with or without myotomy, and myotomy alone. More recently, minimally invasive techniques (such as the transoral endoscopic approach) have become increasingly reliable for this disorder. We therefore conducted this systematic review in order to gain a profound understanding of the current trend and evidence in surgical management of ZD. Methods: Medline and PubMed were searched to identify studies on surgical intervention of ZD published in English between January 1990 and March 2011. Results: We identified 6,915 patients from 93 studies evaluating the effect of the surgical intervention for ZD. No randomized controlled trials comparing one technique with another were identified. Conclusion: Diverticulectomy with myotomy has become the mainstream treatment option for ZD. In certain selected patients, endoscopic diverticulotomy may offer some advantages over open surgery, such as less trauma and a lower complication rate. It is important to individualize optimal therapy for each patient. More randomized controlled trials with long-term follow-up results are required to draw a valid conclusion on the best surgical intervention modality for ZD.

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Section: Search Resultsmentioning

confidence: 99%

Section: Flexible Endoscopic Diverticulotomymentioning

confidence: 99%

Section: Flexible Endoscopic Diverticulotomymentioning

confidence: 99%

Section: Flexible Endoscopic Diverticulotomymentioning

confidence: 99%

See 2 more Smart Citations

Surgical Treatment of Zenker's Diverticulum

Yao¹,

Zhao²,

Hu³

et al. 2013

Dig Surg

151

152

View full text Add to dashboard Cite

show abstract

“…Performed by endoscopists (gastroenterologists or surgeons), it was first introduced in 1995 4 as an alternative to open surgical and rigid endoscopic techniques; however, outcome data are still relatively limited, and, except for one small series, are from studies performed outside the United States. [4][5][6][7][8][9][10][11] Preliminary data suggest that flexible endoscopic therapy may result in similar success rates, low recurrence rates, and low complication rates, with several added advantages 1 : the procedure is performed without general anesthesia and in an outpatient setting, and resumption of oral intake is more rapid. In this case series, we describe the Mayo Clinic experience with flexible endoscopic CP myotomy and several important outcome measures.…”

mentioning

confidence: 99%

Flexible Endoscopic Management of Zenker Diverticulum: The Mayo Clinic Experience

Case

Baron

2010

Mayo Clinic Proceedings

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Postoperative Complications and Reoperative Surgery in the Treatment of Patients With Zenker Diverticulum

Uoti

Nurminen

Andersson

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceThe association of the surgical approach, surgical specialty, and other factors with the outcomes of surgical treatment of Zenker diverticulum (ZD) have been debated in the literature.ObjectivesTo explore the outcomes of 3 different surgical methods used in the management of ZD and determine the associations between patient characteristics, such as preoperative comorbidities and treatment outcomes.Design, Setting, and ParticipantsThis retrospective, population-based cohort study examined patient records of patients who underwent surgical treatment for ZD from the Care Register for Healthcare database in Finland between January 1996 and December 2015. Data review and analysis were completed in 2021.ExposureSurgical treatment for ZD.Main Outcome and MeasuresComplications of surgical procedures used in the management of ZD.ResultsIn this study, 1044 patients (median [IQR] age, 70.0 [22.0-98.0] years; 416 female individuals [39.8%]) surgically treated for ZD were identified. Most patients (606 [58.0%]) had no preoperative comorbidities. A total of 67 (6.4%) complications were recorded, with a mortality rate of 0.9%. The likelihood of complications was associated with patient age (t [1042] = 2.28; Cohen d, 0.29; 95%, CI 0.04, 0.54), surgical approach (Cramer V = 0.14 [95% CI 0.07-0.21]), and surgical specialty (Cramer V, 0.16; 95% CI, 0.06-0.28). The median (IQR) length of stay in association with the primary surgical intervention was 3.0 (0-85.0) days. Length of stay was associated with patient age (Cramer V, 0.14; 95% CI, 0.06-0.25), especially in patients older than 90 years, surgical approach (F [2, 466.2] = 26.9; ηp2 = 0.08; 95% CI, 0.05-0.11), and surgical specialty (F [4, 22.1] = 11.0; ηp2 = 0.07; 95% CI, 0.04-0.10). Reoperation was associated with the initial surgical approach (Cramer V, 0.18; 95% CI, 0.12-0.23) and surgical specialty (Cramer V, 0.14; 95% CI, 0.09-0.21).Conclusions and RelevanceThe results of this cohort study suggest that the outcomes of surgical management depended on the surgical approach, surgical specialty, and patient age. Overall, surgical treatment may be considered safe and may be considered for all patients with symptomatic ZD.

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Flexible Endoscopic Treatment of Zenker's Diverticulum: a New Approach

Cited by 160 publications

References 0 publications

Surgical Treatment of Zenker's Diverticulum

Surgical Treatment of Zenker's Diverticulum

Flexible Endoscopic Management of Zenker Diverticulum: The Mayo Clinic Experience

Postoperative Complications and Reoperative Surgery in the Treatment of Patients With Zenker Diverticulum

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