Flexible endoscopic treatment of Zenker's diverticulum: a new approach.
OBJECTIVE
In the past, a number of treatment modalities have been used for the management of a Zenker's diverticulum. These include transcervical diverticulectomy, myotomy, or laser or diathermy treatment via rigid endoscopes. Up to the present, no reports of the treatment of a Zenker's diverticulum with a flexible endoscope have been published.


METHODS
In this study, we present the results of our first 20 patients (13 male; mean age 82 years) prospectively treated with a flexible endoscope applied through diathermy. All patients had significant symptoms such as dysphagia, recurrent aspiration pneumonia and/or weight loss.


RESULTS
Treatment using a mean of three sessions per patient was successful, with a good symptomatic response in all subjects. There were no severe complications associated with the therapy. Four patients complained about a sore throat for a few days. During follow-up (mean 6-7 months), three patients died due to unrelated causes, and 17 remained asymptomatic.


CONCLUSIONS
An important advantage is that it is possible to perform the treatment without general anesthesia, and therefore also in patients whose general health is poor. The technique can easily be performed in an interventional endoscopy unit. Our first experiences show that flexible endoscopic treatment is an effective and relatively safe method.
Department of Hepatogastroenterology, Rijnstate Hospital, Arnhem, The Netherlands.
C J
CJ
Mulder
G
G
den Hartog
R J
RJ
Robijn
J E
JE
Thies
D000368:Aged; D000369:Aged, 80 and over; D004564:Electrocoagulation / Q000295:instrumentation*; D019723:Endoscopes; D004867:Equipment Design; D020701:Esophagoscopes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D016672:Zenker Diverticulum / Q000601:surgery*