Zenker's diverticulum: Submucosal tunneling endoscopic septum division (Z-POEM)

摘要

Zenker's diverticulum is characterized by dysphagia, weight loss and bronchoaspiration.1 Open surgery has been the cornerstone of treatment with good response but recurrence of up to 35%.2 Rigid endoscopic diverticulo-tomy has similar results, but with conversion to open surgery of up to 30%.3 Flexible endoscopic diverticulo-tomy is safe, effective and can be carried out in an endoscopic setting, but multiple sessions are needed because of incomplete cutting of the septum. ' Z-POEM is a new procedure in which a total septum myotomy throughout a submucosal tunnel can be carried out. We describe this technique in an 85 year-old-man with large Zenker0s diverticulum.