Background: Zenker's diverticulum (ZD) is an uncommon disease, which is typically treated surgically. The alternative to surgery is a diverticulotomy, performed endoscopically. Given the rarity of this condition, it is not possible to obtain training. There has been no animal model identified that resembles the disease in human beings.

Objective: To present an animal model of ZD that resembles the disease in human beings.

Design: We prospectively characterized the endoscopy, the radiography, and the histologic anatomy of the pharyngeal diverticulum in the pig.

Settings: Domestic pigs scheduled for euthanasia underwent radiography and endoscopy and, after euthanasia, neck dissection of the pharyngeal diverticulum.

Interventions And Methods: Thirteen consecutive animals were studied. Pictures were taken for the endoscopic view, as well as radiographies during barium swallow in 1 pig. The neck region was dissected, and the pharynx and the upper esophagus were extracted. The size of the diverticulum was measured, and the block was fixed in formalin. Fixed specimens were cut in the transverse and coronal axis, and pictures were taken. The septum between the diverticulum and the esophagus was reviewed microscopically.

Results: The pharyngeal diverticulum measured an average of 2.7 cm (1.3-5 cm), depending on the size of the pig. From an endoscopic and radiologic perspective, the pig pharyngeal diverticulum is identical to a ZD. The septum contains muscle as well as fibrous tissue and fat. These anatomical characteristics closely resemble the anatomy in human beings.

Conclusions: We believe that we established an animal training model for the endoscopic treatment of ZD.

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http://dx.doi.org/10.1016/j.gie.2006.10.052DOI Listing

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Article Synopsis
  • The study focused on patients with Zenker's diverticulum who were treated using cricopharyngeal myotomy with flexible endoscopic septal division.
  • A total of 15 patients underwent this procedure, with a reported clinical success rate of 80%, although 20% experienced a return of symptoms.
  • The findings suggest that despite new techniques in endoscopy, traditional cricopharyngeal myotomy is still an effective treatment for this condition.
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Objective: To assess the long-term outcomes after endoscopic treatment of patients with Zenker's diverticulum.

Material And Methods: A single-center retrospective study included 207 patients with Zenker's diverticulum who underwent surgery between July 2014 and November 2021. There were 213 interventions including surgeries for recurrence.

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Objective: To compare reflux symptoms, Zenker's diverticulum recurrence, and clinical outcomes in patients with and without a history of hiatal hernia who underwent Zenker's diverticulotomy (ZD).

Study Design: Single institution retrospective review.

Setting: Tertiary care academic hospital.

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Objective: Zenker diverticulum is a mucosal herniation at the pharyngoesophageal junction. Although open surgical myotomy is the conventional treatment, robust evidence on third-space flexible endoscopic myotomy is lacking. We assessed safety, effectiveness, and patient-reported outcomes of per-oral endoscopic myotomy (Z-POEM) in the largest reported single-center experience with this technique.

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