Modern methods of diagnosis and endoscopic treatment Zenker’s diverticulum

Objective. To evaluate the possibilities of using tunnel dissection in the submucosal layer of the esophagus with dissection of the cricopharyngeal muscle during intraluminal endoscopy in the treatment of Zenker’s diverticulum. Material and methods. Two groups were formed. The main group included 23 patients aged 32 to 79 years (mean age 66 years, 11 women, 12 men), who underwent dissection of the cricopharyngeal muscle in the submucosal layer of the esophagus using the tunnel dissection method. The comparison group included 72 patients aged 47 to 85 years (mean age 64 years, 34 women, 38 men), who underwent surgical intervention with transection of the cricopharyngeal muscle and diverticulectomy from the cervical approach in the period from 2016 to 2023. Results. The following parameters were assessed: hospital stay, myotomy length, surgery duration, postoperative observation period, number of complications, and preliminary treatment results. The main group demonstrated statistically significantly shorter surgery time, hospital stay, blood loss, and postoperative observation period than the comparison group (p<0.01). No intraoperative complications were registered in either the main or comparison groups. Postoperative complications in the main group were 4.7% and 7.1% in the comparison group. Conclusion. Endoscopic treatment of patients with Zenker’s diverticulum is currently an alternative to the traditional surgical method. Endoscopic tunnel diverticulotomy allows to effectively restore oral food intake and has a low incidence of intra- and postoperative complications. The technique of endoscopic tunnel cricopharyngoesophagomoitomy complies with the basic principles of surgical treatment of Zenker’s diverticulum as a neuromuscular disease, as well as for the prevention of neoplasms in the diverticulum.