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Endoscopic Staple Diverticulostomy for Zenker Diverticulum

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Management of Zenker and Hypopharyngeal Diverticula

Abstract

Endoscopic treatment of Zenker diverticulum became more readily accepted with the descriptions of the use of the Endo GIA stapler to divide and “seal” the common wall between the esophagus and the diverticulum. This technique creates an esophagodiverticulostomy and has consistently led to relief of patient symptoms with decreased rates of complications as compared to other endoscopic approaches. Treatment of Zenker diverticulum with endoscopic staple diverticulostomy offers the ability for patients to have rapid convalescence with resumption of regular diet in most cases. This chapter will discuss the surgical technique, expected outcomes, and possible complications of this approach while comparing ESD to other endoscopic approaches.

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References

  1. Mosher HP. Webs and pouches of the esophagus, their diagnosis and treatment. Surg Gynecol Obstet. 1917;25:175–87.

    Google Scholar 

  2. Dohlman G, Mattsson L. The endoscopic operation for hypopharyngeal diverticula. A roentgencinematographic study. Arch Otolaryngol Head Neck Surg. 1960;71:744–52.

    Article  CAS  Google Scholar 

  3. van Overbeek JJ. Meditation on the pathogenesis of hypopharyngeal (Zenker’s) diverticulum and a report of endoscopic treatment in 545 patients. Ann Otol Rhinol Laryngol. 1994;103:178–85.

    Article  PubMed  Google Scholar 

  4. Martin-Hirsch DP, Newbegin CJ. Autosuture GIA gun: a new application in the treatment of hypopharyngeal diverticula. J Laryngol Otol. 1993;107:723–5.

    Article  CAS  PubMed  Google Scholar 

  5. Collard JM, Otte JB, Kestens PJ. Endoscopic stapling technique of esophagodiverticulostomy for Zenker’s diverticulum. Ann Thorac Surg. 1993;56:573–6.

    Article  CAS  PubMed  Google Scholar 

  6. Scher RL, Richtsmeier WJ. Endoscopic staple-assisted esophagodiverticulostomy for Zenker’s diverticulum. Laryngoscope. 1996;106:951–6.

    Article  CAS  PubMed  Google Scholar 

  7. Chang C, Payyapilli R, Scher RL. Endoscopic staple diverticulostomy for Zenker’s diverticulum: review of literature and experience in 159 consecutive patients. Laryngoscope. 2003;113:957–65.

    Article  PubMed  Google Scholar 

  8. Wilken R, Whited C, Scher RL. Endoscopic staple diverticulostomy for Zenker’s diverticulum: review of experience in 337 cases. Ann Otol Rhinol Laryngol. 2015;124:21–9.

    Article  PubMed  Google Scholar 

  9. Thaler ER, Weber RS, Goldberg AN, Weinstein GS. Feasibility and outcome of endoscopic staple-assisted esophagodiverticulostomy for Zenker’s diverticulum. Laryngoscope. 2001;111:1506–8.

    Article  CAS  PubMed  Google Scholar 

  10. Richtsmeier WJ. Myotomy length determinants in endoscopic staple-assisted esophagodiverticulostomy for small Zenker’s diverticula. Ann Otol Rhinol Laryngol. 2005;114:341–6.

    Article  PubMed  Google Scholar 

  11. McGuire J, Wright IC, Leverment JN. Surgical staplers: a review. J R Coll Surg Edinb. 1997;42:1–9.

    PubMed  CAS  Google Scholar 

  12. Richtsmeier WJ, Monzon JR. Postendoscopic Zenker esophagodiverticulostomy leaks associated with a specific stapler cartridge. Arch Otolaryngol Head Neck Surg. 2002;128:137–40.

    Article  PubMed  Google Scholar 

  13. Hollinger LD. Patient examination, endoscopy and biopsy. In: Cummings CW, Fredrickson JM, editors. Otolaryngology – head and neck surgery, vol. III. St. Louis: CV Mosby; 1986. p. 2264.

    Google Scholar 

  14. Acharya A, Jennings S, Douglas S, Mirza S, Beasley N. Carcinoma arising in a pharyngeal pouch previously treated by endoscopic stapling. Laryngoscope. 2006;116:1043–5.

    Article  PubMed  Google Scholar 

  15. Herbella FA, Dubecz A, Patti MG. Esophageal diverticula and cancer. Dis Esophagus. 2012;25:153–8.

    Article  CAS  PubMed  Google Scholar 

  16. Chekan E, Whelan RL. Surgical stapling device-tissue interactions: what surgeons need to know to improve patient outcomes. Med Devices (Auckl). 2014;7:305–18.

    PubMed Central  Google Scholar 

  17. Roth JA, Sigston E, Vallance N. Endoscopic stapling of pharyngeal pouch: a 10-year review of single versus multiple staple rows. Otolaryngol Head Neck Surg. 2009;140:245–9.

    Article  PubMed  Google Scholar 

  18. Jaramillo MJ, McLay KA, McAteer D. Long-term clinico-radiological assessment of endoscopic stapling of pharyngeal pouch: a series of cases. J Laryngol Otol. 2001;115:462–6.

    PubMed  CAS  Google Scholar 

  19. Ong CC, Elton PG, Mitchell D. Pharyngeal pouch endoscopic stapling—are post-operative barium swallow radiographs of any value? J Laryngol Otol. 1999;113:233–6.

    Article  CAS  PubMed  Google Scholar 

  20. Hadley JM, Ridley N, Djazaeri B, et al. The radiological appearances after the endoscopic cricopharyngeal myotomy: Dohlman’s procedure. Clin Radiol. 1997;52:613–5.

    Article  CAS  PubMed  Google Scholar 

  21. Sydow B, Levine MS, Rubesin SE, et al. Radiographic findings and complications after surgical or endoscopic repair of Zenker’s diverticulum in 16 patients. AJR Am J Roentgenol. 2001;177:1067–71.

    Article  CAS  PubMed  Google Scholar 

  22. Scher RL, Richtsmeier WJ. Long-term experience with endoscopic staple-assisted esophagodiverticulostomy for Zenker’s diverticulum. Laryngoscope. 1998;108:200–5.

    Article  CAS  PubMed  Google Scholar 

  23. Peracchia A, Bonavina L, Narne S, et al. Minimally invasive surgery for Zenker’s diverticulum: analysis of results in 95 consecutive patients. Arch Surg. 1998;133:695–700.

    Article  CAS  PubMed  Google Scholar 

  24. Barton MD, Detwiller KY, Palmer AD, Schindler JS. The safety and efficacy of endoscopic Zenker’s diverticulotomy: a cohort study. Laryngoscope. 2016;126(12):2705–10.

    Article  PubMed  Google Scholar 

  25. Cook RD, Huang PC, Richstmeier WJ, et al. Endoscopic staple-assisted esophagodiverticulostomy: an excellent treatment of choice for Zenker’s diverticulum. Laryngoscope. 2000;110:2020–5.

    Article  CAS  PubMed  Google Scholar 

  26. Paleri V, Najim O, Meikle D, Wilson JA. Microlaryngoscopic repair of iatrogenic pharyngeal pouch perforations: treatment of choice? Head Neck. 2007;29:189–92.

    Article  PubMed  Google Scholar 

  27. Koay CB, Commins D, Bates GJ. The role of endoscopic stapling diverticulotomy in recurrent pharyngeal pouch. J Laryngol Otol. 1998;112:954–5.

    Article  CAS  PubMed  Google Scholar 

  28. Scher RL. Endoscopic staple diverticulostomy for recurrent Zenker’s diverticulum. Laryngoscope. 2003;113:63–7.

    Article  PubMed  Google Scholar 

  29. Payne WS. The treatment of pharyngoesophageal diverticulum: the simple and complex. Hepatogastroenterology. 1992;39:109–14.

    PubMed  CAS  Google Scholar 

  30. Ellis F. Pharyngoesophageal (Zenker’s) diverticulum. Adv Surg. 1995;28:171–89.

    PubMed  Google Scholar 

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Correspondence to William J. Richtsmeier .

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Richtsmeier, W.J., Scher, R.L. (2018). Endoscopic Staple Diverticulostomy for Zenker Diverticulum. In: Scher, R., Myssiorek, D. (eds) Management of Zenker and Hypopharyngeal Diverticula. Springer, Cham. https://doi.org/10.1007/978-3-319-92156-3_6

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  • DOI: https://doi.org/10.1007/978-3-319-92156-3_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92155-6

  • Online ISBN: 978-3-319-92156-3

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