Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA.
Expert Rev Gastroenterol Hepatol. 2012 Aug;6(4):449-65; quiz 466. doi: 10.1586/egh.12.25.
Zenker's diverticulum is an outpouching of the mucosa through the Killian's triangle. The etiology of Zenker's diverticulum is not well understood. It is thought to be due to the incoordination or incomplete relaxation of the cricopharyngeal muscle. Most patients are men who present with symptoms of dysphagia between the seventh and eighth decades of life. The diagnosis is made with a dynamic contrast swallowing study. Treatment options include open surgical diverticulectomy and diverticulopexy with myotomy or myotomy alone using flexible or rigid endoscopes. Rigid endoscopic treatment is currently the preferred initial choice for Zenker's diverticulum of any size. The flexible endoscopic technique is used when there is a high risk of general anesthesia, or neck extension is contraindicated. Some centers use flexible endoscopy as the initial treatment option. Due to a lack of prospective studies, the treatment choice should be tailored to the individual patient and local expertise.
Zenker 憩室是穿过 Killian 三角的黏膜外袋。Zenker 憩室的病因尚不清楚。它被认为是由于环咽肌不协调或不完全松弛。大多数患者为男性，在第七至第八个十年出现吞咽困难症状。诊断方法是动态对比吞咽研究。治疗选择包括开放式外科憩室切除术和憩室固定术，伴有肌切开术或单独肌切开术，可使用灵活或刚性内窥镜。对于任何大小的 Zenker 憩室，刚性内窥镜治疗目前是首选的初始选择。当存在全身麻醉风险较高或颈部伸展受限时，使用灵活的内窥镜技术。一些中心将灵活的内镜检查作为初始治疗选择。由于缺乏前瞻性研究，治疗选择应根据患者个体和当地专业知识进行调整。
