title: Endoscopic treatment for Zenker's diverticulum: long-term results (with video).
abstract: BACKGROUND
  Diverticulotomy is a standard treatment for Zenker's diverticulum (ZD). This technique was adapted to flexible endoscopy.
  
  
  OBJECTIVE
  We report our long-term results of ZD treatment by using flexible endoscopy assisted by a soft diverticuloscope.
  
  
  METHODS
  Follow-up study.
  
  
  METHODS
  Academic hospital. Tertiary-care referral center.
  
  
  METHODS
  A total of 150 patients with ZD were treated with the same technique from July 2002 to June 2011.
  
  
  METHODS
  The procedure was performed by using a soft diverticuloscope to expose the septum, which was then cut with a needle-knife, and the procedure was completed by use of endoclip placement at the bottom of the section.
  
  
  METHODS
  Symptoms were compared before and after the procedure, 1 month later, and at the end of follow-up.
  
  
  RESULTS
  The median size of the ZD was 3 cm (range 1-8 cm). The endoscopic incision was performed in one session (range 1-3 sessions). Clinical success at 1 month was 90.3%. Four adverse events (2.2%) occurred and were managed conservatively. Symptom evaluation at 1 month and at the end of follow-up was obtained in 103 and 134 patients, respectively. The dysphagia score dropped from 1.88 to 0.29 (P < .01) and 0.34 (P < .05) at 1 month and at the end of follow-up, respectively (median 43 months, range 13-121 months). Regurgitations and chronic cough dropped from 73% and 27% to 11% and 2% at the end of follow-up, respectively. Symptom recurrence occurred in 31 patients (23.1%); among them 23 had a second treatment, and only 5 required a third one.
  
  
  CONCLUSIONS
  Retrospective study, single center.
  
  
  CONCLUSIONS
  Endoscopic incision of ZD by using a soft diverticuloscope and completed by endoclips is safe and efficient at short term and long term.
authors: Medical-Surgical Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors: Vincent
authors: V
authors: Huberty
authors: Souraya
authors: S
authors: El Bacha
authors: Daniel
authors: D
authors: Blero
authors: Olivier
authors: O
authors: Le Moine
authors: Sergio
authors: S
authors: Hassid
authors: Jacques
authors: J
authors: Devière
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003371:Cough / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000150:complications / Q000601:surgery*