Different therapeutic approaches to Zenker diverticulum: A retrospective comparative study between the flexible endoscopic method using needle knife and the rigid endoscopic method using laser in terms of effectiveness, complications and recurrence rates

Abstract

Zenker’s diverticulum is an outpouching at the pharyngoesophageal junction causing dysphagia, regurgitation and aspiration. Myotomy may be performed by open, rigid or flexible endoscopy. This retrospective study compared flexible needle‑knife endoscopy (gastroenterology) and rigid laser myotomy (ENT). From 2009–2021, 136 patients were treated (88 flexible, 48 rigid). Flexible endoscopy showed shorter procedure time and hospitalization (p < 0.05). Complication and recurrence rates were similar, but subjective symptom improvement was higher (88.7% vs. 65.5%; p < 0.05). Flexible endoscopy may provide greater effectiveness with comparable safety