Traditional septotomy or Z-POEM for Zenker's diverticulum.

Area of Science:

• Gastroenterology and Endoscopy
• Otolaryngology
• Surgical Innovation

Background:

• Zenker's diverticulum (ZD), or cricopharyngeal pouch, is a pharyngoesophageal pseudodiverticulum.
• Pathophysiology involves cricopharyngeal dysfunction leading to dysphagia, regurgitation, and other symptoms.
• Symptomatic ZD traditionally requires cricopharyngeal muscle myotomy.

Purpose of the Study:

• To review and compare endoscopic techniques for Zenker's diverticulum treatment.
• To analyze clinical outcomes of flexible endoscopy septotomy (FES) and Zenker peroral endoscopic myotomy (Z-POEM).
• To guide treatment selection based on clinical scenarios and diverticulum size.

Main Methods:

• Review of current literature on FES and Z-POEM for Zenker's diverticulum.
• Analysis of technique variations in FES.
• Evaluation of Z-POEM effectiveness and impact of diverticulum size on outcomes.

Main Results:

• Endoscopic techniques like FES and Z-POEM are preferred minimally invasive options for ZD.
• Variability exists in FES techniques; Z-POEM demonstrates effectiveness.
• Diverticula size impacts treatment outcomes, influencing the choice between FES and Z-POEM.

Conclusions:

• FES and Z-POEM offer effective, minimally invasive treatment for Zenker's diverticulum.
• Choosing between FES and Z-POEM depends on specific clinical factors and diverticulum characteristics.
• Further analysis of technique variations and size-dependent outcomes is crucial for optimizing ZD management.