Open AccessEsophageal diverticulum: New perspectives in the era of minimally invasive endoscopic treatment
Author(s) -
Hiroki Sato,
Manabu Takeuchi,
Satoru Hashimoto,
Kenichi Mizuno,
Koichi Furukawa,
Akito Sato,
Junji Yokoyama,
Shuji Terai
Publication year - 2019
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v25.i12.1457
Subject(s) - medicine , diverticulum (mollusc) , myotomy , dysphagia , esophageal disorder , esophageal motility disorder , endoscopy , chest pain , surgery , esophagus , achalasia
Esophageal diverticula are rare conditions that cause esophageal symptoms, such as dysphagia, regurgitation, and chest pain. They are classified according to their location and characteristic pathophysiology into three types: epiphrenic diverticulum, Zenker's diverticulum, and Rokitansky diverticulum. The former two disorders take the form of protrusions, and symptomatic cases require interventional treatment. However, the esophageal anatomy presents distinct challenges to surgical resection of the diverticulum, particularly when it is located closer to the oral orifice. Since the condition itself is not malignant, minimally invasive endoscopic approaches have been developed with a focus on alleviation of symptoms. Several types of endoscopic devices and techniques are currently employed, including peroral endoscopic myotomy (POEM). However, the use of minimally invasive endoscopic approaches, like POEM, has allowed the development of new disorder called iatrogenic esophageal diverticula. In this paper, we review the pathophysiology of each type of diverticulum and the current state-of-the-art treatment based on our experience.