Zenker's diverticulum: a new endoscopic treatment with a soft diverticuloscope.
BACKGROUND
Recently developed treatments for Zenker's diverticulum include the use of a flexible endoscope, which is minimally invasive. A new endoscopic approach is described that uses a soft diverticuloscope to provide perfect exposure of the operative site and stabilizes the endoscope.


METHODS
A total of 30 patients (15 men, 15 women; median age, 78 years) were treated with this diverticuloscope. All patients had significant symptoms including dysphagia (n = 24, 80%) and/or regurgitation (n = 17, 56%). Eighteen (60%) had a large diverticulum (>4 cm).


RESULTS
All patients were successfully treated in a single session. In one patient, dysphagia persisted but was milder than before the treatment. A complication occurred in 4 patients (13%); in one (3%), it was severe. During follow-up (median, 12.5 months), dysphagia recurred in one patient 1 year after the initial procedure but was successfully re-treated with a CO(2) laser and rigid diverticuloscope. Four patients (13%) died during follow-up of causes unrelated to the treatment.


CONCLUSIONS
Diverticulotomy with a flexible endoscope and soft diverticuloscope is an effective treatment for Zenker's diverticulum.
Evrard
Sylvie
S
Department of Gastroenterology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Le Moine
Olivier
O
Hassid
Sergio
S
Devière
Jacques
J
D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010865:Pilot Projects; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000175:diagnosis* / Q000601:surgery*