Manometric study of the upper esophageal sphincter before and after endoscopic management of Zenker's diverticulum.
OBJECTIVE
Zenker's diverticulum treatment was done by endoscopic management of the elderly and debilitated patients without general anesthesia.


METHODS
With this technique, the septum between the diverticulum and the esophageal lumen is sectioned with a diathermic knife. Since the upper esophageal sphincter (UES) is certainly included in the mass sectioned, this accounts for the success of the procedure.


RESULTS
Manometric assessment of the UES was done in 5 patients before the endoscopic treatment. The mean pressure was 54.6 cm H2O and the mean length of 3 cm. A significant (p < 0.05) reduction in maximum pressure occurred postoperatively--mean 26.8 cm H2O. There was no significant variation in length of the UES.


CONCLUSIONS
The maintenance of this basal pressure may be explained by the preservation of the circular muscle structure of the region, with sphincter-like characteristics.
Ishioka
S
S
Gastrointestinal Endoscopy Unit, University of Sao Paulo Medical School, Brazil.
Felix
V N
VN
Sakai
P
P
Melo
J
J
Pinotti
H W
HW
D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D004943:Esophagogastric Junction / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000503:physiopathology* / Q000601:surgery