Results of the Endoscopic Treatment of Patients With Zenker’s DIVERTICULUM

Aims Endoscopic techniques are currently a priority in treating patients with Zenker’s diverticulum (ZD). Nevertheless, standard endoscopic treatment is associated with an increased number of disease relapses – up to 20 %. On the one hand, the tunnel technique allows performing the adequate volume of myotomy regardless of the diverticulum size. On the other hand, the residual cavity of the diverticulum can be left, which determines the potential risk of recurrence. Therefore we have developed a novel technique that combines all the advantages of standard and tunnel operations.

Methods In the period from July 2014 to November 2020, endoscopic operations for ZD were performed in 170 patients. The average diverticulum size was 2.8 cm (0.5 to 7 cm). 34 patients were operated using the standard technique and 38 patients using the tunnel technique. The average time of surgery in the two groups was 40 minutes. 98 patients were operated on using the combined technique. The average time of surgery was 35 minutes. Upper esophageal myotomy up to 3-7 cm, depending on the size of the diverticulum, was performed in addition to tunnel and combined techniques.

Results All patients underwent EGD 3 and 12 months after surgery, followed by annual endoscopic control. In the presence of complaints, an additional X-ray examination was performed. Over the entire follow-up period, 4 (11.8 %) patients operated by the standard technique in the postoperative period revealed a relapse of clinical manifestations of the disease, which required a total of 7 (17.1 %) repeated operations. After tunnel and combined operations, no relapse of the disease was encountered. No complications in the postoperative period were observed in all three groups.

Conclusions The study has shown the high efficiency of combined interventions in the treatment of ZD. Therefore this technique can be used regardless of the size of diverticulum.

Citation: Pavlov I, Shishin K, Nedoluzhko I et al. eP32 RESULTS OF THE ENDOSCOPIC TREATMENT OF PATIENTS WITH ZENKER’S DIVERTICULUM. Endoscopy 2021; 53: S107.

Publication History

Article published online:
19 March 2021