Zapping Zenker's diverticulum: gastroscopic treatment

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Zenker's diverticulum (ZD) commonly causes dysphagia in elderly patients.
• Many elderly patients are poor surgical candidates.
• Endoscopic treatment offers an alternative for these patients.

Purpose of the Study:

• To evaluate the safety and efficacy of gastroscopic treatment for Zenker's diverticulum.
• To assess outcomes in elderly patients, including those with contraindications for general anesthesia.

Main Methods:

• One hundred twenty-five patients with ZD underwent endoscopic treatment.
• The Zenker's bridge was divided using argon plasma coagulation, monopolar forceps, and/or other endoscopic tools.
• Patients received antibiotics and sedation; radiography confirmed no leakage before diet normalization.

Main Results:

• All 125 patients were successfully treated, with symptomatic improvement.
• The median age was 77 years; treatment was effective even in frail patients.
• Complications included emphysema (n=17) and bleeding (n=2); 30-day mortality was zero.

Conclusions:

• Endoscopic treatment of Zenker's diverticulum is safe and effective.
• This approach allows treatment for all ZD patients, including the elderly and those unfit for surgery.
• Successful outcomes were achieved in patients previously unresponsive to surgical or ENT interventions.