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Endoscopy 2007; 39(2): 141-145
DOI: 10.1055/s-2007-966164
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Argon plasma coagulation for flexible endoscopic Zenker’s diverticulotomy

T.  Rabenstein1 , A.  May1 , J.  Michel1 , H.  Manner1 , O.  Pech1 , L.  Gossner1 , C.  Ell1
  • 1Department of Medicine II, Dr.-Horst-Schmidt-Kliniken Wiesbaden, Wiesbaden, Germany
Further Information

Publication History

eingereicht 26 September 2006

akzeptiert 20 December 2006

Publication Date:
27 February 2007 (online)

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Commentaire de “Traitement endoscopique du diverticule de Zenker: le choix des armes”, pp. 141, 131, 137, 146Endoscopy 2007; 39(02): 193-193
DOI: 10.1055/s-0032-1306914

Background and study aims: The increasing use of flexible endoscopy to treat symptomatic Zenker’s diverticulum is only partially supported by data on safety and benefits. This retrospective study reports the mid-term results of argon plasma coagulation (APC) for flexible endoscopic therapy of Zenker’s diverticulum.

Patients and methods: Between January 2002 and July 2006, 41 patients (27 men, 14 women, mean age ± standard deviation [SD] 73 ± 11 years) were treated by means of APC flexible endoscopic Zenker’s diverticulotomy. Technical and immediate clinical success (on a 3-month control examination) was assessed for the entire group. Mid-term follow-up data were obtained for patients treated until December 2005 (n = 34) with a mean ± SD follow-up period of 16 ± 5 months.

Results: Technical success was achieved in all 41 patients, with a mean ± SD of 3 ± 2 treatment sessions during one or two hospitalizations (1 - 3 sessions for 78 % patients, > 3 sessions for 22 % patients). Immediate clinical success was achieved in 95 % of cases. Fever occurred in seven patients (17 %), lasting less than 24 hours in three patients (7 %) and associated with clinical infections in four (10 %); one perforation occurred, which was managed conservatively. In the patients for whom we had mid-term follow-up data, 5/34 experienced recurrence and achieved a successful clinical outcome after retreatment with APC.

Conclusions: APC treatment of Zenker’s diverticulum is safe and effective in the short term, with a mean of three treatment sessions. Recurrence rates of around 15 % have to be expected on mid-term follow-up. The relative value of APC vs. needle-knife techniques can only be clarified in a prospective randomized study.

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T. Rabenstein, MD

Department of Medicine II

Dr.-Horst-Schmidt-Kliniken Wiesbaden

Academic Teaching Hospital of the Johannes-Gutenberg-University Mainz

Ludwig-Erhard-Str. 100

65199 Wiesbaden

Germany

Fax: +49-611-432418

Email: thomas.rabenstein@hsk-wiesbaden.de