Flexible Endoscopic Treatment of Zenker's Diverticulum: A Center Experience and Literature Review
Published: 2023-06-19
Page: 44-57
Issue: 2023 - Volume 6 [Issue 1]
I. Radouane *
Department of Gastroenterology, Avicenne Military Hospital, Marrakech, Morocco.
R. Akka
Department of Gastroenterology, Avicenne Military Hospital, Marrakech, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Zenker's pharyngo-oesophageal diverticulum is a rare acquired hernia of the posterior mucosa at the pharyngo-oesophageal junction. The pathophysiology of this condition is still poorly understood.
Our article aims to shed light on the epidemiological, clinical, paraclinical and therapeutic aspects of this pathology.
By adopting a retrospective study, we followed 3 patients with Zenker's diverticulum, between January 2019 and December 2022, in our department of Hepato-gastro-enterology.
They were 3 men aged 58, 54 and 90 years with a median age of 67.3 years.
The clinical symptoms observed were dominated by upper dysphagia and regurgitation in all cases (100%). One patient had also weight loss as a complication (33%).
The endoscopic examination combined with the cervico-thoracic CT scan allowed the diagnosis in all our patients (100%), with an average size of 3.5 cm (1.5-4 cm) for the diverticulum.
The treatment adopted for our 3 patients was endoscopic diverticulotomy performed with a diverticuloscope. . The procedure duration was 35+/- 5 minutes with simple aftercare.
The patients resumed oral feeding the next day, despite minimal postoperative pain. The median hospitalisation duration was 2 days and the average follow-up time was 12 months. Clinical success was 100% and no complications were noted.
In conclusion, endoscopic diverticulotomy is an effective treatment to quickly improve symptoms while reducing hospitalization length and complications risk, especially in elderly patients with comorbidities.
Keywords: Zenker's diverticulum, flexible endoscopic treatment, efficacity
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