Ishioka S, Felix V N, Sakai P, Melo J, Pinotti H W
Gastrointestinal Endoscopy Unit, University of Sao Paulo Medical School, Brazil.
Hepatogastroenterology. 1995 Sep-Oct;42(5):628-32.
BACKGROUND/AIM: Zenker's diverticulum treatment was done by endoscopic management of the elderly and debilitated patients without general anesthesia.
MATERIALS/METHODS: With this technique, the septum between the diverticulum and the esophageal lumen is sectioned with a diathermic knife. Since the upper esophageal sphincter (UES) is certainly included in the mass sectioned, this accounts for the success of the procedure.
Manometric assessment of the UES was done in 5 patients before the endoscopic treatment. The mean pressure was 54.6 cm H2O and the mean length of 3 cm. A significant (p < 0.05) reduction in maximum pressure occurred postoperatively--mean 26.8 cm H2O. There was no significant variation in length of the UES.
The maintenance of this basal pressure may be explained by the preservation of the circular muscle structure of the region, with sphincter-like characteristics.
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