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Hépato-Gastro & Oncologie Digestive

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Prise en charge du diverticule de Zenker Volume 30, numéro 2, Février 2023

Vidéos

  • Septotomie endoscopique souple avec diverticuloscope
  • Z-POEM

Illustrations


  • Figure 1

  • Figure 2

  • Figure 3

  • Figure 4

  • Figure 5
Auteur
Ramsay Santé, Hôpital Privé Jean Mermoz, Service d’endoscopie digestive, 55 avenue Jean Mermoz, 69008 Lyon
* Correspondance : V. Lépilliez

Zenker’s Diverticulum, named after Dr Friedrich Albert von Zenker (1825-1898) who in 1877 reported a series of 23 cases and first hypothesized its pathophysiology, is an uncommon pathology, occurring in elderly patients, predominantly males. It is suspected by the association of dysphagia and regurgitation, and diagnosed by a barium swallow radiography with video fluoroscopy. For a long time, its treatment was reserved for open surgery, then rigid endoscopy performed by ENT surgeons, despite a high morbidity rate for the former and technical limitations for the latter. Finally, the first septotomy with a flexible endoscope was reported very recently in 1995 by two different teams. Since then, endoscopic techniques have been adapted over the last two decades with increasing success and safety profile replacing conventional surgery as first line treatment according to ESGE recommendations (European Society of Gastrointestinal Endoscopy). This mini-review aims to provide a synthesis of therapeutic methods with emphasis on the availability of flexible endoscopy and its future progress with the advent of Z-POEM.