Song XR, Liu YX, Wu XF, Xue R. Esophageal diverticulum: A clinical framework for patient-tailored endoscopic management. World J Gastroenterol 2026; 32(40): 120622 [DOI: 10.3748/wjg.120622]
Corresponding Author of This Article
Ran Xue, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Early Drug Development Center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. xueran2@sina.com
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Gastroenterology & Hepatology
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review-article
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Song XR, Liu YX, Wu XF, Xue R. Esophageal diverticulum: A clinical framework for patient-tailored endoscopic management. World J Gastroenterol 2026; 32(40): 120622 [DOI: 10.3748/wjg.120622]
World J Gastroenterol. Oct 28, 2026; 32(40): 120622 Published online Oct 28, 2026. doi: 10.3748/wjg.120622
Esophageal diverticulum: A clinical framework for patient-tailored endoscopic management
Xin-Ran Song, Yu-Xi Liu, Xiao-Feng Wu, Ran Xue
Xin-Ran Song, School of Clinical Medicine, Capital Medical University, Beijing 100069, China
Yu-Xi Liu, School of Clinical Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing 101149, China
Xiao-Feng Wu, Ran Xue, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Early Drug Development Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
Ran Xue, Department of Gastroenterology, Beijing Chao‑Yang Hospital, Capital Medical University, Beijing, 100020, China
Co-first authors: Xin-Ran Song and Yu-Xi Liu.
Author contributions: Xue R conceived and designed the paper; Song XR, Liu YX, and Wu XF wrote the manuscript and analyzed the data. All authors read and approved the final manuscript. Song XR and Liu YX are co-first authors of this work. They contributed equally to the writing of the manuscript, data analysis, and interpretation of the results. Both authors participated in the revision of the manuscript and approved the final version. Their respective contributions are of equal importance and are inseparable in the completion of this study. Therefore, co-first authorship is fully justified.
AI contribution statement: DeepSeek and GeenMedical were used during the preparation of this manuscript. No portion of the main text (Abstract, Introduction, Materials and Methods, Results, Discussion, Conclusion) was directly generated by AI. The AI tool was only used for language refinement and grammar checking. AI tool was used for language polishing, translation and writing assistance. No AI tool was used for data analysis. AI did not participate in the study design or interpretation of results. No AI-generated images are included in this manuscript.
Supported by grants from Beijing Xisike Clinical Oncology Research Foundation, No. Y-SY2024QN-0110; and Science Foundation of Peking University Cancer Hospital, No. BJCH2026GG03.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Ran Xue, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Early Drug Development Center, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. xueran2@sina.com
Received: March 4, 2026 Revised: April 15, 2026 Accepted: May 27, 2026 Published online: October 28, 2026 Processing time: 191 Days and 2.6 Hours
Abstract
The management of esophageal diverticula is undergoing a paradigm shift from traditional surgery to minimally invasive endoscopic approaches. However, achieving precise treatment based on individual patient characteristics remains a significant challenge. This paper aims to establish a comprehensive clinical decision-making framework for esophageal diverticulum, encompassing diagnosis, preoperative evaluation, method selection, specific therapeutic techniques, and postoperative assessment, with the goal of facilitating precision treatment. In the preoperative evaluation section, we conduct a detailed analysis of endoscopic approach selection based on diverticulum size, anatomical location, septum length, and patient surgical history, and further discussed recent advances in endoscopic techniques. Additionally, we provide an in-depth comparison of the advantages and disadvantages of different energy modalities, devices, and therapeutic strategies, emphasizing the need for postoperative assessment to account for both technical and clinical success. Lastly, we suggest that the integration of endoscopic techniques with artificial intelligence may represent a future direction for development.
Core Tip: This review establishes a comprehensive decision-making framework for the endoscopic treatment of esophageal diverticula, encompassing the multi-dimensional preoperative assessment of patients, precise selection of techniques and devices, and dual evaluation of postoperative outcomes. The core perspective lies in emphasizing the formulation of individualized strategies based on diverticulum characteristics and patient conditions, assisting in achieving precision medicine in clinical practice.
