Abstract
The treatment of Zenker diverticulum has faced a substantial evolution during the last century. The traditional open surgical approach has been progressively flanked and subsequently almost completely overcome by the less invasive and easier transoral approach.
Transoral stapling of the septum between the diverticulum and the esophagus and laser diverticulotomy has gained consensus, being minimally invasive, relatively inexpensive, and associated with very few complications. However, they require the placement of a rigid diverticuloscope and general anesthesia. The placement of the diverticuloscope is not possible in all the patients and especially in the elderly.
Since its introduction in 1995, flexible endoscope-assisted cricopharyngeal myotomy quickly became one of the first-line treatments for the Zenker diverticulum. The procedure is performed by using a 9-mm endoscope, under sedation. Age of patients, previous treatments, and impossibility to hyperextend the neck are no longer limits for the transoral treatment. The outcomes of the procedure are excellent. The advent of peroral endoscopic myotomy additionally expanded the therapeutic possibilities, with promising results also in the treatment of the smallest pouches.
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Costamagna, G., Familiari, P., Landi, R. (2021). Indication, Technique, and Results of Endoscopic Cricomyotomy. In: Horgan, S., Fuchs, KH. (eds) Innovative Endoscopic and Surgical Technology in the GI Tract . Springer, Cham. https://doi.org/10.1007/978-3-030-78217-7_9
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