Year 2016 / Volume 108 / Number 6
Original
Flexible endoscopic treatment of Zenker’s diverticulum: thirteen years’ experience in Spain

297-303

DOI: 10.17235/reed.2016.4030/2015

Emilio Jesús de la Morena Madrigal, Elena Pérez Arellano, Isabel Rodríguez García,

Abstract
Introduction: Flexible endoscopic treatment is one of the alternative approaches for the management of Zenker’s diverticum. The present paper shows our short-term and long-term results with flexible endoscopic cricopharyngeal myotomy/septotomy. Patients and methods: A retrospective analysis of our experience in patients with Zenker’s diverticulum treated using a flexible endoscope, assisted by a flexible diverticuloscope, between 2002 and 2015. Myotomy/septotomy was performed with a needle-knife papillotome under deep sedation or general anesthesia. Results: Among the 64 patients treated, two died within 10 days of surgery from causes not directly related to the procedure, and one presented with pharyngo-esophageal perforation, which recovered with conservative management at 47 days after admission. Four additional patients were lost to short-term follow-up. Among the 57 remaining patients, 52 had complete relief of dysphagia after 6 weeks. Eleven of these had recurrent symptoms on the mid and the long term. Eight were retreated with the same flexible endoscopic technique, one with a hybrid endoscopic approach, one with classical open surgery and one refused retreatment. After a mean follow-up of 2 years and a half, 33 of 37 patients reported absent or minimal dysphagia, controllable with punctual dietary restrictions. Conclusions: Flexible endoscopic treatment for Zenker’s diverticulum is effective and safe. It represents an option on an equal footing to rigid endoscopy and classical open surgery and may also be used when the latter two are technically impracticable or contraindicated.
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de la Morena Madrigal E, Pérez Arellano E, Rodríguez García I. Flexible endoscopic treatment of Zenker’s diverticulum: thirteen years’ experience in Spain . 4030/2015


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Publication history

Received: 02/10/2015

Accepted: 14/02/2016

Online First: 08/04/2016

Published: 03/06/2016

Article revision time: 126 days

Article Online First time: 189 days

Article editing time: 245 days


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