Flexible Endoscopic Management of Zenker Diverticulum: The Mayo Clinic Experience

August 2010
Mayo Clinic Proceedings;Aug2010, Vol. 85 Issue 8, p719
Academic Journal
OBJECTIVE: To describe the outcome of patients undergoing flexible endoscopic therapy for symptomatic Zenker diverticulum. PATIENTS AND METHODS: We retrospectively evaluated the outcome of 22 consecutive patients who underwent flexible endoscopic cricopharyngeal myotomy using needle-knife electrocautery performed by a single endoscopist from March 2006 through January 2010. RESULTS: Of the 22 patients with symptomatic Zenker diverticulum, 13 were men and 9 were women (median age, 84.5 years). Moderate sedation was used in all but 3 (14%) of the patients. Postprocedural free air occurred in 6 patients (27%) and resolved uneventfully in all. Another patient developed a neck abscess 1 week after endoscopic treatment, which was surgically drained. All procedures were performed on an outpatient basis, although 8 patients (36%) required subsequent hospitalization. The mean (SD) length of stay in the hospital was 2.9 (1.64) days. All patients had initial symptomatic improvement, and 18 (82%) maintained improvement at a mean (SD) follow-up of 12.7 (9.2) months. CONCLUSION: Flexible endoscopic cricopharyngeal myotomy is an effective treatment of symptomatic Zenker diverticulum, with low recurrence rates and with the benefit of no general anesthesia and hospitalization In most cases. Esophageal perforation is the most common procedural complication.


Related Articles

  • The Role of Pharmacoeconomic Evaluations in Disease Management. Chang, K.; Nash, D. // PharmacoEconomics;1998, Vol. 14 Issue 1, p11 

    Disease management is a systematic approach to a health condition or a healthcare intervention that organises preventative, interventional and care approaches throughout the continuum of care and which measures outcomes in terms of populations, not individuals. Disease management's advantage...

  • The impact of bundled payments for diabetes care on curative health care costs - A 2-year follow-up study based on Dutch nationwide claim data. Mohnen, Sigrid M.; Baan, Caroline A.; Struijs, Jeroen N. // International Journal of Integrated Care (IJIC);Oct2013 Supplement, Vol. 13, p1 

    Introduction: In The Netherlands, disease management programs (DMPs) based on Bundled Payment (BP) for chronic diseases were initiated to, inter alia, slow down the costs growth. To date, it is unknown whether the BP model for diabetes care increased or reduced the cost growth in comparison to...

  • Return on Investment in Disease Management: A Review. Goetzel, Ron Z.; Ozminkowski, Ronald J.; Villagra, Victor G.; Duffy, Jennifer // Health Care Financing Review;Summer2005, Vol. 26 Issue 4, p1 

    The results of 44 studies investigating financial impact and return on investment (ROI) from disease management (DM) programs for asthma, congestive heart failure (CHF), diabetes, depression, and multiple illnesses were examined. A positive ROI was found for programs directed at CHF and multiple...

  • Changing the Treatment Paradigm: Moving to Multimodal and Integrated Osteoarthritis Disease Management. Brander, Victoria // Journal of Family Practice;Nov2011 Supplement 2, pS41 

    The article discusses the changes of treatment and management of osteoarthritis (OA) disease. It notes the importance of an improved treatment and management of OA follwing the increasing number of patients with such disease. It examines how OA care delivery using disease-management strategies...

  • Milliman offers guidance on disease management.  // Modern Healthcare;8/16/2004, Vol. 34 Issue 33, p33 

    Presents information on a study which examined regression to the mean and selection bias, elements that often confound cost-benefit analyses of disease management. Three disease states that are typically addressed by disease management programs; Effects of selection bias on the utilization and...

  • Doctor-patient relationships in chronic illness: insights from forensic psychiatry. Campbell, Colin; McGauley, Gill // BMJ: British Medical Journal (International Edition);3/19/2005, Vol. 330 Issue 7492, p667 

    Examines the psychological impact of chronic diseases on patients and physicians. Impact of chronic diseases on world health systems; Suggestion that a lack of possible cure for chronic diseases causes frustration on the part of physicians; Discussion of treating the chronic diseases of patients...

  • Old vs. Young Docs: Younger is Better. Reisinger, Christine // Review of Optometry;3/15/2005, Vol. 142 Issue 3, p4 

    The article reports that older doctors may provide lower quality of care than younger doctors. Researchers at Harvard Medical School reviewed 59 previously published papers that comprised 62 studies with a large sample size of doctors. The studies included measures of physician knowledge or...

  • Disease Management Outcomes: Are We Asking the Right Questions Yet? Norman, Gordon K. // Population Health Management;Aug2008, Vol. 11 Issue 4, p183 

    The author reflects on the efficacy of disease management (DM) to improve processes of care, adherence to evidence-based guidelines, and clinical outcomes in the U.S. He also examines whether DM programs consistently produce return on investment (ROI), meaning short-term net savings for the...

  • An innovative approach to targeting pain in older people in the acute care setting. Phelan, Caroline // Contemporary Nurse: A Journal for the Australian Nursing Profess;2010, Vol. 35 Issue 2, p221 

    This paper reports the findings of an exploratory pilot study which used mixed methods to determine (a) the feasibility of the study design for a larger multi site project and (b) whether a pain education promotion approach, termed 'Targeting Pain', using a multidisciplinary educational campaign...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics