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Revista Colombiana de Cirugía

Print version ISSN 2011-7582On-line version ISSN 2619-6107

Abstract

HOYOS-RINCON, Marcela; FUENTES-DIAZ, Carlos Fernando  and  RODRIGUEZ-FAJARDO, Jesús Antonio. Z-POEM: Ideal procedure for the treatment of Zenker’s diverticulum?. rev. colomb. cir. [online]. 2023, vol.38, n.2, pp.252-258.  Epub Jan 27, 2023. ISSN 2011-7582.  https://doi.org/10.30944/20117582.2284.

Introduction.

Zenker’s diverticulum is a rare pathology characterized by the presence of dysphagia, halitosis, cough, and weight loss, which affect the patients' quality of life. The treatment is surgical and the techniques have evolved permanently. The objective of this study was to evaluate the improvement of dysphagia in patients who underwent peroral endoscopic myotomy technique (Z-POEM).

Methods.

Descriptive study of a series of 23 patients with Zenker’s diverticulum diagnosed by endoscopy and esophagram, treated between May 2018 and November 2021 at different institutions in Bogotá, Colombia, by means of an endoscopic cricopharyngeal myotomy with the Z-POEM technique.

Results.

Most of patients were older males. The most frequent symptoms corresponded to dysphagia and regurgitation. The average size of the diverticulum was three centimeters. The hospital stay was one day. One patient presented postoperative dysphagia related to the clips and another presented a mediastinal abscess which was resolved endoscopically. Currently, all patients are asymptomatic and have not presented recurrence.

Conclusions.

Minimally invasive endoscopic treatment by peroral endoscopic myotomy (Z-POEM) in patients with Zenker’s diverticulum is a safe and effective alternative, with good results and low morbidity.

Keywords : Zenker diverticulum; esophageal diverticulum; upper esophageal sphincter; swallowing disorders; endoscopic surgery; myotomy.

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