FLEXIBLE ENDOSCOPIC TREATMENT OF ZENKERS DIVERTICULUM - A NEW APPROACH

Background and Study Aims: In the past, a number of treatment modaliti es have been used for the management of a Zenker's diverticulum. These include transcervical diverticulectomy, myotomy, or laser or diatherm y treatment via rigid endoscopes. Up to the present, no reports of the treatment of a Zenker's diverticulum with a flexible endoscope have b een published. Patients and Methods: In this study, we present the res ults of our first 20 patients (13 male; mean age 82 years) prospective ly treated with a flexible endoscope applied through diathermy, All pa tients had significant symptoms such as dysphagia, recurrent aspiratio n pneumonia and/or weight loss. Results: Treatment using a mean of thr ee sessions per patient was successful, with a good symptomatic respon se in all subjects. There were no severe complicatins associated with the therapy, Four patients complained about a sore throat for a few da ys. During follow-up (mean 6-7 months), three patients died due to unr elated causes, and 17 remained asymptomatic. Conclusions: An important advantage is that it is possible to perform the treatment without gen eral anesthesia, and therefore also in patients whose general health i s poor. The technique can easily be performed in an interventional end oscopy unit, Our first experiences show that flexible endoscopic treat ment is an effective and relatively safe method.