Endoscopic treatment of recurrent Zenker diverticulum and postoperative esophageal stricture

• Published in: Hirurgija (Moskva) no. 3; p. 70
• Main Authors: Starkov, Yu G, Vagapov, A I, Badakhova, A B, Zamolodchikov, R D, Dzhantukhanova, S V
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 2024
• Subjects: Diverticulum; Endoscopy - adverse effects; Esophageal Stenosis; Female; Humans; Middle Aged; Postoperative Complications - etiology; Quality of Life; Zenker Diverticulum - surgery; Zenker diverticulum; endoscopic treatment; endoscopic cricopharyngoesophagomyotomy; surgical endoscopy of the esophagus
• ISSN: 0023-1207
• DOI: 10.17116/hirurgia202403170

Zenker diverticulum is a rare disease accounting for 1.5-5% of esophageal diverticula. For a long time, surgical treatment of Zenker pharyngoesophageal diverticula implied open diverticulectomy via cervical approach. However, this intervention is characterized by high postoperative morbidity and recurrence rate. Oral endoscopic minimally invasive cricopharyngoesophagomyotomy has become widespread over the past 10 years. We present a 55-year-old female who underwent endoscopic treatment for recurrent Zenker diverticulum and postoperative esophageal stricture. We obtained favorable result in a patient with recurrent Zenker diverticulum after previous open surgeries complicated by esophageal stricture. Endoscopic management eliminated recurrent diverticulum and esophageal stricture, as well as improved the quality of life. Endoscopic approach is preferable for pharynoesophageal diverticula compared to traditional surgical diverticulectomy. Obvious advantages of this technique are stable functional result, low incidence of complications and mortality, short-term postoperative period with fast rehabilitation. Extended myotomy is essential for successful oral endoscopic cricopharyngoesophagomyotomy.