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 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

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.

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

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 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.

scholarly journals Harmonic scalpel for endoscopic treatment of Zenker's diverticulum: a critical review of the literature

2017 ◽  
Vol 7 (11) ◽  
pp. 264-272
Author(s):  
Nadim Khadem ◽  
Shadaba Ahmed
Keyword(s):  
Treatment Option ◽  
Harmonic Scalpel ◽  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Efficacy And Safety ◽  
Review Of The Literature ◽  
Viable Option ◽  
Effective Treatment Option ◽  
Zenker's Diverticulum

Introduction: Endoscopic staple-assisted diverticulostomy (ESD) is generally accepted as the preferred treatment option for patients with Zenker’s diverticulum (ZD). However, anatomical factors may preclude the use of ESD in certain patients. In recent years, the harmonicscalpel has been introduced as an alternative device for endoscopic management of ZD, which may be useful in certain cases where diverticulum anatomy prevents the use of ESD. This review aims to assess the efficacy and safety of endoscopic ZD-repair using the harmonic-scalpel, including comparative analysis of the harmonic and staple assisted approaches in terms of their surgical outcomes. Conclusion: Most studies support the use of the harmonic-scalpel as a safe and effective treatment option for ZD. Although the harmonic-assisted technique may not replace ESD as the initial treatment of choice for ZD, it may serve as a useful adjunct to treatment in selected cases. However, given the low quality of evidence and concerns regarding treatment complications, large prospective randomised trials comparing the harmonic and staple-assisted techniques are necessary in order to determine whether the harmonic-scalpel is truly a viable option for endoscopic ZD-management.

Efficacy and Safety of Flexible Endoscopic Management of Zenker’s Diverticulum

2018 ◽  
Vol 52 (5) ◽  
pp. 369-385 ◽  
Author(s):  
Deepanshu Jain ◽  
Abhinav Sharma ◽  
Manan Shah ◽  
Upen Patel ◽  
Nirav Thosani ◽  
...  
Keyword(s):  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Efficacy And Safety ◽  
Zenker's Diverticulum

Endoscopic management of a non-Zenker’s diverticulum

2001 ◽  
Vol 71 (8) ◽  
pp. 493-494
Author(s):  
Tim Iseli ◽  
Christopher Brown ◽  
Stephen Kleid
Keyword(s):  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Zenker's Diverticulum

scholarly journals Endoscopic management of Zenker’s diverticulum

2015 ◽  
Vol 06 (02) ◽  
pp. 045-054 ◽  
Author(s):  
Harpal S. Dhaliwal ◽  
Saroj K. Sinha ◽  
Rakesh Kochhar
Keyword(s):  
Flexible Endoscopy ◽  
Endoscopic Management ◽  
Zenker’S Diverticulum ◽  
Mortality And Morbidity ◽  
Endoscopic Techniques ◽  
Zenker's Diverticulum ◽  
Neck Anatomy ◽  
Endoscopic Myotomy ◽  
Underlying Pathophysiology

AbstractZenker’s diverticulum (ZD) is a posterior hypopharyngeal mucosal and submucosal outpouching through an area of relative muscular weakness, known as Killian’s triangle. It is an uncommon but highly treatable cause of mechanical dysphagia in elderly patients. Diagnosis is established by esophagography and upper endoscopy. The treatment has evolved with the advancement in the understanding of underlying pathophysiology. Traditionally, the management had been open surgical exposure and cricopharyngeal myotomy, combined with diverticular excision, suspension or inversion. Peroral endoscopic techniques (rigid and flexible) have gained popularity as minimally invasive and effective therapeutic options, with lesser mortality and morbidity. Flexible endoscopic myotomy offers additional benefits over rigid endoscopic techniques, as it does not require general anesthesia and neck hyperextension. The initial results of flexible endoscopy are quite encouraging, but long-term data are not yet available. For the optimal outcome, flexible endotherapy requires a formidable endoscopic skill, sound knowledge of the neck anatomy and meticulous understanding of the electrosurgical principles. In this article, we have comprehensively reviewed the current understanding of the pathophysiology involved and various techniques used in the management of ZD, with a focus on flexible endoscopic techniques.

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