Achkar E
Department of Gastroenterology, Cleveland Clinic Foundation, Ohio 44195, USA.
Dig Dis. 1998 May-Jun;16(3):144-51. doi: 10.1159/000016858.
Zenker's diverticulum is a pouch protruding posteriorly above the upper esophageal sphincter, in the Killian's triangle, an area of relative weakness. Zenker's diverticulum was thought, for many years, to occur as a result of cricopharyngeal incoordination but more recent evidence points to poor upper sphincter compliance with diminished sphincter opening and increased hypopharyngeal pressures. Small Zenker's diverticula may be asymptomatic. As they become larger, symptoms include dysphagia, food regurgitation, and a sensation of globus. The best diagnostic method is a barium swallow with attention to the cricopharyngeal area. Although gastroesophageal reflux may be responsible for many throat symptoms, the relationship of reflux to the pathogenesis of Zenker's diverticulum is speculative. The treatment of Zenker's diverticulum is surgical. There have been many variations in technique over the years. Diverticulectomy with cricopharyngeal myotomy remains the most frequently performed operation. Endoscopic treatment with or without laser stapling has been reported but is not popular in the United States.
Zenker憩室是一个在 Killian 三角区（相对薄弱的区域）食管上括约肌上方后方突出的囊袋。多年来，Zenker憩室被认为是环咽肌不协调的结果，但最近的证据表明，上括约肌顺应性差，括约肌开口减小，下咽压力增加。小的 Zenker憩室可能无症状。随着憩室变大，症状包括吞咽困难、食物反流和咽部异物感。最佳诊断方法是吞咽钡剂并关注环咽肌区域。虽然胃食管反流可能是许多咽喉症状的原因，但反流与 Zenker憩室发病机制的关系尚属推测。Zenker憩室的治疗是手术治疗。多年来手术技术有很多变化。憩室切除术加环咽肌切开术仍然是最常进行的手术。有报道称采用或不采用激光吻合器进行内镜治疗，但在美国并不流行。
