Cricopharyngomyotomy: Outcomes of flexible endoscopic management of small and medium sized Zenker's diverticulum.

BACKGROUND

Zenker's diverticulum (ZD) was historically treated with an open transcervical myotomy with diverticulectomy, but endoscopic approaches have gained popularity, though with little recent data. This study aimed to report flexible endoscopic cricopharyngomyotomy (FEC) outcomes, particularly in smaller diverticula.

METHODS

Patients with ZD treated with FEC at a tertiary center were reviewed. Patients were grouped by diverticulum size: small (sZD)≤1.5 ​cm; medium (mZD) ​> ​1.5 ​cm.

RESULTS

Of 30 patients, median age, BMI, sex, and comorbidities were similar between sZD (n ​= ​18) and mZD (n ​= ​12). Overall, 80.0 ​% had the procedure performed with a needle knife. Median number of clips for mucosotomy closure (5.0[5.0,6.0]vs.7.0[5.0,7.0]clips;p ​= ​0.051), operative time (59.5[51.0,75.0]vs.74.5[51.0,93.5]minutes;p ​= ​0.498), length-of-stay (1.0[1.0,1.0]vs.1.0[1.0,1.0]days;p ​= ​0.397), and follow-up (20.8[1.1,33.4]vs.15.6[5.4,50.4]months;p ​= ​0.641) were comparable. There were no postoperative leaks; incomplete myotomy occurred in one sZD, yielding a clinical success rate of 96.7 ​%.

CONCLUSIONS

FEC has a high success rate for ZD and an advantage in small diverticula, difficult to treat with stapling or open technique.

Informations de copyright

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Déclaration de conflit d'intérêts

Declaration of competing interest P. Colavita, MD is a research grant recipient from Medtronic; however, this grant is unrelated to the study and has not affected the objectivity of the data. A. Holland, MD, W. Lorenz, MD, A. Ricker, MD, B. Mead, MD, and G. Scarola, MS have no conflicts of interest or financial ties to disclose. There is nothing related to intellectual property that needs to be disclosed. Authors do not participate in any activities or organizations that may compete with or impact this study. This study was not funded by any outside entity other than ourselves, including specific funding agencies in the public, commercial, or not-for-profit sectors. Finally, we have not utilized artificial intelligence writing assistance in the creation of this manuscript.