Transluminal endoscopic methods of treatment of Zenker’s diverticulum and transaxillary endovideosurgical diverticulectomy: a clinical case series

Abstract

INTRODUCTION. The Zenker’s diverticulum is a protrusion of the wall of the pharyngeal-esophageal junction from the area of the Killian triangle as a result of persistent spasm of the cricopharyngeal muscle. The prevalence of the disease in Russia is 3 cases per 100 thousand people, in the world 0.01–0.11 %.METHODS AND MATERIALS . At the N. N. Burdenko Faculty Surgery Clinic of the I. M. Sechenov First Moscow State Medical University 2 patients with small diverticulum underwent endoscopic tunnel cricopharyngeal myotomy and 3 patients with large diverticulum underwent video-assisted transaxillary diverticulectomy.RESULTS . Compared with surgical methods for the treatment of Zenker’s diverticulum endoscopic methods have a lower complication rate, but a higher recurrence rate.CONCLUSION. Despite the introduction of new treatment methods, it is advisable to adhere to a differentiated approach to the treatment of Zenker’s diverticulum. Surgical treatment is indicated for patients with a large diverticulum in the absence of contraindications to surgery. Transluminal endoscopic methods, including cricopharyngeal tunnel myotomy, can be considered as a treatment for patients with small-sized Zenker’s diverticulum, as well as patients with large diverticulum who have concomitant diseases and contraindications to traditional surgery.

Keywords

• zenker’s diverticulum
• dysphagia
• transluminal endoscopic treatment
• tunnel cricopharyngeal myotomy
• videoassisted transaxillary diverticulectomy