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Devices and techniques for flexible endoscopic management of Zenker’s diverticulum (with videos) - 18/06/21

Doi : 10.1016/j.gie.2021.02.020 
Prepared by:Pichamol Jirapinyo, MD, MPH 1, , Amrita Sethi, MD, FASGE 2, , Barham K. Abu Dayyeh, MD, MPH, FASGE 3, Manoop S. Bhutani, MD, FASGE 4, Vinay Chandrasekhara, MD, FASGE 5, Nikhil A. Kumta, MD, MS 6, Joshua Melson, MD, MPH, FASGE 7, Rahul Pannala, MD, MPH, FASGE 8, Erik F. Rahimi, MD 9, Guru Trikudanathan, MBBS 10, John T. Maple, DO, FASGE 11 : (previous Committee Chair, 2016-2019), David R. Lichtenstein, MD, FASGE 12 : (ASGE Technology Committee Chair)
1 Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA 
2 Department of Digestive and Liver Diseases, Columbia University Medical Center/New York-Presbyterian Medical Center, New York, New York, USA 
3 Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 
4 Department of Gastroenterology Hepatology and Nutrition, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA 
5 Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 
6 Division of Gastroenterology, Mount Sinai Hospital, New York, New York, USA 
7 Division of Digestive Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA 
8 Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA 
9 Department of Gastroenterology, Baylor Scott & White Health, Lakeway, Texas, USA 
10 Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA 
11 Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA 
12 Division of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA 

Abstract

Background and Aims

Zenker’s diverticulum (ZD) has traditionally been treated with open surgery or rigid endoscopy. With the advances in endoscopy, alternative flexible endoscopic treatments have been developed.

Methods

This document reviews current endoscopic techniques and devices used to treat ZD.

Results

The endoscopic techniques may be categorized as the traditional flexible endoscopic septal division and the more recent submucosal tunneling endoscopic septum division, also known as peroral endoscopic myotomy for ZD. This document also addresses clinical outcomes, safety, and financial considerations.

Conclusions

Flexible endoscopic approaches treat symptomatic ZD with results that are favorable compared with traditional open surgical or rigid endoscopic alternatives.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : AE, ASGE, CP, ESD, FESD, POEM, STESD, TTS, ZD, Z-POEM


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 This document is from the American Society for Gastrointestinal Endoscopy Technology Committee and was reviewed and approved by the Governing Board of the American Society for Gastrointestinal Endoscopy.
 The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methods are used, with a MEDLINE literature search to identify pertinent clinical studies on the topic. This is supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases data from randomized controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review the MEDLINE database was searched through March 2019 for articles related to endoscopic treatment of Zenker’s diverticulum by using keywords such as “endoscopy” or “endoscopic” combined with “Zenker” or “Zenker’s diverticulum,” among others. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment.


© 2021  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 94 - N° 1

P. 3-13 - luglio 2021 Ritorno al numero
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  • Vinay Chandrasekhara, Nikhil A. Kumta, Barham K. Abu Dayyeh, Manoop S. Bhutani, Pichamol Jirapinyo, Kumar Krishnan, John T. Maple, Joshua Melson, Rahul Pannala, Mansour A. Parsi, Amrita Sethi, Guru Trikudanathan, Arvind J. Trindade, David R. Lichtenstein, (American Society for Gastrointestinal Endoscopy Technology Committee Chair)
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