Copyright ©The Author(s) 2019.
World J Gastroenterol. Mar 28, 2019; 25(12): 1457-1464
Published online Mar 28, 2019. doi: 10.3748/wjg.v25.i12.1457
Table 1 Summary of the characteristics of epiphrenic and Zenker’s diverticula and their treatment options
Epiphrenic diverticulumThe right wall of the distal esophagus is the most common site. Pulsion-type pseudodiverticulum. Generally detected after middle-age. No difference in incidence between the sexes. More than 75% of cases occur concomitantly with esophageal motility disorders. Symptoms: dysphagia, regurgitation, chest painSurgical treatment; Removal of the diverticulum with myotomy through the LES and fundoplication
Endoscopic treatment (flexible endoscope); s-POEM (myotomy through the LES); D-POEM (POEM diverticulectomy)
Zenker’s diverticulumArises from Killian’s triangle in the pharyngoesophagus. Pulsion-type pseudodiverticulum. Incidence: 2 per 100000 person-years, Prevalence: 0.01%-0.11% (United States, Europe > Asia)[42,43]. Common in the 7th-8th decade, male predominance[44]. Symptoms: dysphagia, regurgitationSurgical treatment; Transcervical diverticulectomy, diverticuloplexy, or diverticular inversion.
Diverticulectomy with rigid endoscope; Harmonic scalpel, CO2 laser, endostapler, etc.
Diverticulectomy with flexible endoscope
Clutch Cutter, Stag Beetle knife, D-POEM, etc.