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Endoscopy 2001; 33(11): 991-997
DOI: 10.1055/s-2004-826106
The Expert Approach
© Georg Thieme Verlag KG Stuttgart · New York

Zenker's Diverticulum: Treatment Using a Flexible Endoscope

C. J. J. Mulder1 , G.  Costamagna2 , P.  Sakai3
  • 1Dept. of Gastroenterology, Rijnstate Hospital, Arnhem, The Netherlands
  • 2Dept.of Surgery, Universita Cattolica del Sacro Cuore, Rome, Italy
  • 3Gastrointestinal Endoscopy Unit, University of Sãao Paulo, São Paulo, Brazil
The aim of the Expert Approach section is to contribute to the dissemination and standardization of new endoscopie procedures. Authors from three distinct geographic areas combine forces, sharing their experience to form a consensus of opinion. Readers' comments are welcome and will be published in the Mailbox which appears at the end of each Expert Approach article.Committee:Chairman: R. Lambert (Lyon)Specialists: R. Kozarek (Seattle), H. Inoue (Tokyo), P. Sakai (Sao Paulo), H. Neuhaus (Düsseldorf), C. Neumann (Birmingham)
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Publication Date:
25 October 2004 (online)

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Introduction

The pharyngoesophageal diverticulum has been called Zenker's diverticulum (ZD); we define the latter as a posterior diverticulum with its neck proximal to the cricopharyngeal muscle. Most authors consider such pouches to be a type of esophageal diverticulum. Diverticula are outpouchings of one or more layers of the esophageal wall, and occur in three main areas: 1) immediately above the upper esophageal sphincter (ZD); 2) near the midpoint of the esophagus (traction diverticulum); and 3) immediately above the lower esophageal sphincter (epiphrenic diverticulum).

References

  • 1 Barthlen W, Feussner H, Hannig C, et al. Surgical therapy of Zenker's diverticulum: low risk and high efficiency.  Dysphagia. 1990;  5 13-19
    Google Scholar
  • 2 Dohlman G, Mattson O. The endoscopic operation for hypopharyngeal diverticula: a roentgen-cinematographic study.  Arch Otolaryngol. 1960;  71 744-752
    Google Scholar
  • 3 Van Overbeek JJ. Meditation on the pathogenesis of hypopharyngeal (Zenker's) diverticulum and a report of endoscopic treatment in 545 patients.  Ann Otorhinolaryngol. 1994;  103 178-185
    Google Scholar
  • 4 Collard JM, Otte JB, Kestens PJ. Endoscopic stapling technique of esophagodiverticulostomy for Zenker's diverticulum.  Ann Thorac Surg. 1993;  56 573
    Google Scholar
  • 5 Scher RL, Richtsmeier WJ. Long-term experience with endoscopic staple-assisted esophagodiverticulostomy for Zenker's diverticulum.  Laryngoscope. 1998;  108 200-205
    Google Scholar
  • 6 Peracchia A, Bonavina L, Narne S, et al. Minimally invasive surgery for Zenker diverticulum: analysis of results in 95 consecutive patients.  Arch Surg. 1998;  133 695-700
    Google Scholar
  • 7 Philippsen LP, Weisberger EC, Whiteman TS, Schmidt JL. Endoscopic stapled diverticulotomy: treatment of choice for Zenker's diverticulum.  Laryngoscope. 2000;  110 1283-1286
    Google Scholar
  • 8 Overbeek JJM, Hoeksema PE, Edens ET. Microendoscopic surgery of the hypopharyngeal diverticulum using electrocoagulation or carbon dioxide laser.  Ann Otol Rhinol Laryngol. 1984;  93 34-36
    Google Scholar
  • 9 Ishioka S, Sakai P, Maluf Filho F, Melo JM. Endoscopic incision of Zenker's diverticulum: a new approach.  Endoscopy. 1995;  27 438-442
    Google Scholar
  • 10 Mulder CJJ, den Hartog G, Robijn RJ, Thies JE. Flexible endoscopic treatment of Zenker's diverticulum: a new approach.  Endoscopy. 1995;  27 438-442
    Google Scholar
  • 11 Wahab PJ, Mulder CJJ, den Hartog G, Thies JE. Argon plasma coagulation in flexible gastrointestinal endoscopy: pilot experiences.  Endoscopy. 1997;  29 176-181
    Google Scholar
  • 12 Hashiba K, de Paula AL, da Silva JGN, et al. Endoscopic treatment of Zenker's diverticulum.  Gastrointest Endosc. 1999;  49 93-96
    Google Scholar
  • 13 Bremner CG, De Meester TR. Endoscopic treatment of Zenker's diverticulum.  Gastrointest Endosc. 1999;  49 126-128
    Google Scholar

C J J MulderM.D. 

Dept. of Gastroenterology Rijnstate Hospital Arnhem

PO Box 9555 Arnhem 6800 TA The Netherlands

Fax: + 31-26-3786737

Email: cjmulder@rijnstate.nl

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Readers' comments (maximum 200 words, no illustrations) on published topics are welcome, and appear here. Readers are also invited to suggest topics of interest to The Expert Approach committee. All correspondence should be addressed to R. Lambert, M.D., preferably by email. Address: International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 693 72 cedex, France. Fax: +33-4-7273-8650, email: lambert@iarc.fr.

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