What is the efficacy of endoscopic diverticulotomy in the treatment of Zenker diverticulum?

Updated: Feb 25, 2020
  • Author: Joel A Ernster, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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A study by Venkatesan found that after successful endoscopic diverticulotomy in patients with Zenker diverticulum, videofluoroscopic swallow study (VFSS) showed a 50.9% reduction in diverticulum size and a 33.6% reduction in the pharyngeal constriction ratio, as well as a 61.6% increase in the mean pharyngoesophageal segment opening in the lateral view and a 40.0% increase in the anteroposterior view. In addition, the mean value for the Eating Assessment Tool-10 (EAT-10) was reduced by 72.1%, indicating improved swallowing. [37]

In 1917, Mosher first described an endoscopic approach to diverticulotomy but abandoned it because of complications. This approach was reintroduced by Dohlman and Seiffert in 1958. [38] Although these authors reported few complications, other surgeons experienced complications such as mediastinitis and abscess formation, and the technique did not gain widespread acceptance. A cautery unit was used to perform the diverticulotomy. [34, 39, 40, 41, 42]

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