Endoscopic staple diverticulostomy for recurrent Zenker's diverticulum

Area of Science:

• Gastroenterology
• Surgical Innovation
• Digestive Endoscopy

Background:

• Zenker's diverticulum (ZD) can recur after initial treatment, necessitating further intervention.
• Previous treatments for recurrent ZD include endoscopic and external surgical approaches.
• Evaluating novel techniques for managing recurrent ZD is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the technical feasibility, effectiveness, and safety of endoscopic staple diverticulostomy (ESD) for recurrent Zenker's diverticulum (ZD).
• To evaluate ESD as a treatment option for ZD recurring after prior endoscopic or external surgery.
• To determine the morbidity and long-term symptom relief associated with ESD in recurrent ZD cases.

Main Methods:

• Retrospective review of 18 patients with recurrent Zenker's diverticulum (ZD) treated between March 1995 and July 2001.
• Analysis of patient demographics, prior treatment history, recurrence factors, and treatment outcomes.
• Evaluation of technical feasibility, complications, symptom relief duration, and postoperative recovery following ESD for recurrent ZD.

Main Results:

• Endoscopic staple diverticulostomy (ESD) was technically feasible in 16 of 18 patients with recurrent Zenker's diverticulum (ZD).
• Sixteen patients experienced complete or improved symptom relief after revision ESD, with follow-up ranging from 9 to 69 months.
• No significant complications were observed; patients demonstrated rapid recovery, with most resuming a clear liquid diet on the day of surgery and hospital discharge by postoperative day two.

Conclusions:

• Endoscopic staple diverticulostomy (ESD) is an effective, technically feasible, and safe treatment for recurrent Zenker's diverticulum (ZD).
• ESD should be considered the primary treatment of choice for patients with ZD recurrence following prior endoscopic or external interventions.
• The procedure offers durable symptom relief and a favorable safety profile for managing complex ZD cases.