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Updated: May 27, 2026

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
[Zenker diverticulum: surgical versus endoscopic treatment]
Marner Lopes da Silveira1, Daniel Weiss Vilhordo, Cleber Dario Pinto Kruel
1Mestrando em Ciências Cirúrgicas pela Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, RS-BR. marner@terra.com.br
Endoscopic and surgical treatments for Zenker's diverticulum show comparable safety and effectiveness. However, current evidence is limited, preventing definitive conclusions on the optimal approach for this condition.
Area of Science:
- Gastroenterology
- Otolaryngology
- Surgical Innovation
Background:
- Zenker's diverticulum (pharyngoesophageal diverticulum) is a condition requiring treatment.
- Endoscopic and surgical interventions are primary treatment modalities.
Purpose of the Study:
- To systematically review and compare the safety and effectiveness of endoscopic versus surgical treatments for Zenker's diverticulum.
Main Methods:
- A meta-analysis was performed using data from comparative, non-randomized studies identified through MEDLINE, LILACS, and SciELO searches.
- Five studies involving 630 patients (339 endoscopic, 291 surgical) were included after quality assessment.
Main Results:
- No randomized clinical trials were identified.
- Endoscopic treatment showed 0.29% mortality and 7% morbidity; surgical treatment had 0.34% mortality and 5% morbidity.
- Effectiveness rates were similar (84% endoscopic vs. 85% surgical), with comparable odds ratios for morbidity (1.24) and success (0.66).
Conclusions:
- The available evidence for Zenker's diverticulum treatment is of low quality.
- Current studies are insufficient to definitively determine the superior treatment in terms of safety and effectiveness.
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