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The Endoscopic Management of Zenker’s Diverticulum: A Comprehensive Review

Authors :
Giuseppe Dell’Anna
Ernesto Fasulo
Jacopo Fanizza
Rukaia Barà
Edoardo Vespa
Alberto Barchi
Paolo Cecinato
Lorenzo Fuccio
Vito Annese
Alberto Malesci
Francesco Azzolini
Silvio Danese
Francesco Vito Mandarino
Source :
Diagnostics, Vol 14, Iss 19, p 2155 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Zenker’s Diverticulum (ZD) is the most common hypopharyngeal diverticulum; however, it is often underdiagnosed. It results from the herniation of the mucosa and submucosa through Killian’s Triangle. Dysphagia is the primary symptom, occurring in 80–90% of cases. The primary goal of treatment is to transect the cricopharyngeal muscle (CM) and connect the ZD cavity to the esophageal lumen. Traditional treatments include surgical open transcervical diverticulectomy and CM septomyotomy, using rigid or flexible endoscopes. However, surgery is burdened by technical difficulties and not negligible rates of adverse events (AEs). For this reason, endoscopic techniques for ZD treatment have gained traction in recent years. Flexible endoscopic septum division (FESD), introduced nearly 20 years ago, involves a full-thickness incision of the diverticular septum. The advent of third-space endoscopy has led to the application of these techniques to ZD treatment as well. Zenker-POEM (Z-POEM) and, subsequently, Per Oral Endoscopic Septomyotomy (POES) have been developed. Hybrid techniques, such as Peroral Endoscopic Diverticulotomy (POED) and tunneling-free methods, represent additional ZD treatment options. This review outlines the armamentarium of ZD endoscopic management, summarizing the characteristics of these techniques, their benefits and limitations, and highlighting future research directions.

Details

Language :
English
ISSN :
20754418
Volume :
14
Issue :
19
Database :
Directory of Open Access Journals
Journal :
Diagnostics
Publication Type :
Academic Journal
Accession number :
edsdoj.85b7a920613409e87c8541df2dd171f
Document Type :
article
Full Text :
https://doi.org/10.3390/diagnostics14192155