Argon plasma coagulation for flexible endoscopic Zenker's diverticulotomy

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Innovation

Background:

• Zenker's diverticulum treatment is increasingly utilizing flexible endoscopy.
• Data on the safety and efficacy of endoscopic approaches for Zenker's diverticulum remains limited.
• This study evaluates mid-term outcomes of argon plasma coagulation (APC) for this condition.

Purpose of the Study:

• To report the mid-term results of argon plasma coagulation (APC) in flexible endoscopic treatment of Zenker's diverticulum.
• To assess the safety and efficacy of APC in a cohort of patients.
• To determine recurrence rates at mid-term follow-up.

Main Methods:

• A retrospective study involving 41 patients treated with APC flexible endoscopic Zenker's diverticulotomy between 2002 and 2006.
• Technical success and immediate clinical success (3-month follow-up) were evaluated.
• Mid-term follow-up data were collected for 34 patients with a mean follow-up of 16 months.

Main Results:

• All 41 patients achieved technical success, with an average of 3 treatment sessions.
• Immediate clinical success was observed in 95% of patients.
• A 15% recurrence rate was noted at mid-term follow-up, with successful retreatment using APC.

Conclusions:

• Argon plasma coagulation (APC) is a safe and effective short-term endoscopic treatment for Zenker's diverticulum.
• Approximately 15% of patients may experience recurrence within mid-term follow-up.
• Prospective randomized studies are needed to compare APC with other techniques like needle-knife therapy.