32 years of experience with CO2 -LASER-assisted treatment for Zenker's Diverticulum - an update of 227 patients treated in Kiel

2016 ◽  
Vol 42 (3) ◽  
pp. 592-596 ◽  
Author(s):  
M. Hoffmann ◽  
A. Fazel ◽  
K.-G. Mews ◽  
P. Ambrosch
Keyword(s):  
Co2 Laser ◽  
Zenker’S Diverticulum ◽  
Years Of Experience ◽  
Zenker's Diverticulum

CO2 Laser Zenker's Diverticulotomy: 10-year Experience

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P49-P49
Author(s):  
Elie E Rebeiz ◽  
Nitin Bhatia
Keyword(s):  
Co2 Laser ◽  
Tertiary Care ◽  
Postoperative Bleeding ◽  
Retrospective Chart Review ◽  
Zenker’S Diverticulum ◽  
Endoscopic Techniques ◽  
Zenker's Diverticulum ◽  
Surgical Options ◽  
Tissue Sealant ◽  
Carbon Dioxide Co2

Objective Zenker's diverticula occur primarily in older patients, resulting in dysphagia, aspiration, and weight loss. A number of surgical options are available for treatment. While small diverticula (smaller than 2 cm) may require no surgical treatment, the presence of dysphagia, asiration, may necessitate surgery. Surgical options include both traditional open and endoscopic procedures. Many patients are elderly and cannot undergo open surgical procedures. Endoscopic techniques have become the preferred approaches by physicians because of their safety, effectiveness, and fewer complications. Methods Retrospective chart review of 65 patients who underwent endoscopic carbon dioxide (CO2) laser treatment of Zenker's diverticulum at a single tertiary care institution. In some of the procedures, the incision was sealed with a tissue sealant. Results Age ranged from 56 to 89 years. All patients had significant improvement in their symptoms such as dysphagia, aspiration, and weight gain. The endoscopic incision was performed in 1 session using the CO2 laser and a microscope. 2 complications (cervical emphysema) were managed conservatively and 1 postoperative bleeding required return to the operating room. The endoscopic exposure was not achieved in 2 patients due to difficult exposure. There were no mortalities. Mean follow-up was 27 months. There was no recurrence of dysphagia and all patients remained asymptomatic. Conclusions CO2 laser endoscopic treatment of symptomatic Zenker's diverticulum is an effective and safe method. It is quick and simple, and permits a short hospital stay and quick return to activities. Tissue sealant provides additional safety and reduces the incidence of postoperative complications.

Fish Bone Foreign Body in a Zenker's Diverticulum: A Case Report

2017 ◽  
Vol 68 (3) ◽  
pp. 240-244
Author(s):  
Sumiyo Saburi ◽  
Yoichiro Sugiyama ◽  
Hideki Bando ◽  
Ryuichi Hirota ◽  
Yasuo Hisa ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Fish Bone ◽  
Zenker’S Diverticulum ◽  
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.

Long-term success of flexible endoscopic septal division with the stag beetle knife for Zenker’s diverticulum: a tertiary center study

2020 ◽  
Vol 33 (11) ◽  
Author(s):  
Sauid Ishaq ◽  
Keith Siau ◽  
Minhong Lee ◽  
Haleema Sultan ◽  
Shalmani H Mohaghegh ◽  
...  
Keyword(s):  
Cox Regression ◽  
Multivariable Analysis ◽  
Zenker’S Diverticulum ◽  
Long Term Outcome ◽  
Zenker's Diverticulum ◽  
Tertiary Center ◽  
Symptom Remission ◽  
Treatment Naïve ◽  
Symptom Recurrence

Summary Objectives Flexible endoscopic septum division is an established treatment for Zenker’s diverticulum (ZD); however, long-term outcome data are lacking. We aimed to evaluate the long-term efficacy of flexible endoscopic septal division (FESD) using the stag beetle knife for ZD and identify predictors of symptom recurrence. Methods Patients undergoing the procedure between 2013 and 2018 were prospectively enrolled. Procedures were performed by a single operator. Symptom severity pre- and postprocedure was recorded using the dysphagia, regurgitation, and complications scale. Symptom recurrence was defined as a total score > 1 after the index procedure. Time-to-event analyses were performed using Kaplan–Meier plots, with multivariable analyses performed using Cox regression models. Results Altogether, 65 patients (mean age 74.0 years, 60% male) were included. Previous stapling had been performed in 44.6% of patients. Over the mean posttreatment follow-up period of 19 months, 5.6% of the treatment naïve group and 34.5% of the recurrent group underwent repeated FESD (P = 0.003), with rates of symptom remission and improvement of 75.4% and 92.7%, respectively. Recurrence at 48 months was higher in patients with recurrent ZD (84.7%) than in treatment-naïve patients (10.7%). On multivariable analysis, recurrent disease (hazard ratio [HR] 20.8, P = 0.005) and younger age (HR 0.96/year, P = 0.047) were associated with symptom recurrence. Conclusions In patients with treatment-naïve ZD, flexible endoscopic septal division is safe and provides durable symptom remission. However, in patients with poststapling recurrence, the risk of recurrence is high and time-dependent.

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