[Intraluminal therapy for Zenker's diverticulum].
A Zenker's diverticulum (ZD) is a posterior diverticulum with its neck proximal to the cricopharyngeal muscle. Patients typically present after the age of 60 with symptoms ranging from weeks to years. The classical treatment in the past was surgical, which is still the case in the US. They treat them in general with open myotomy and diverticulectomy. Since the 1950s ENT physicians treat them with rigid endoscopes and cut the bridge between the ZD and the esophagus. This method is widely used throughout western Europe. However, many symptomatic elderly patients are poor surgical/ENT candidates. In 1995, two groups from Brazil and The Netherlands reported their first results with a gastroscopic treatment, in which the ZD bridge is cut with a precut needle/monopolar forceps. Recently, argon plasma coagulation has also been introduced in this field. All these treatments seem effective. Comparative trials between these approaches are now long overdue, since all these modalities will work in the hands of experienced "Zenker specialists".
Mulder
C J
CJ
Department of Hepatogastroenterology, Rijnstate Hospital, Arnheim. cjmulder@rijnstate.nl
van den Hazel
S J
SJ
D001128:Argon; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D016672:Zenker Diverticulum / Q000628:therapy*
D001128:Argon
Intraluminale Therapie des Zenker-Divertikels.