The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Zenker Diverticulum Treated by Transparent Cap and Needle Knife

투명캡과 침형 절개도를 이용하여 치료한 젠커게실

  • Park, Chol Jin (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Lee, Jun (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Jang, Kwang Pyo (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Kim, Eun Jeong (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Kim, Young Dae (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Park, Chan Guk (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Kim, Man Woo (Department of Internal Medicine, Chosun University College of Medicine)
  • 박철진 (조선대학교 의과대학 내과학교실) ;
  • 이준 (조선대학교 의과대학 내과학교실) ;
  • 장광표 (조선대학교 의과대학 내과학교실) ;
  • 김은정 (조선대학교 의과대학 내과학교실) ;
  • 김영대 (조선대학교 의과대학 내과학교실) ;
  • 박찬국 (조선대학교 의과대학 내과학교실) ;
  • 김만우 (조선대학교 의과대학 내과학교실)
  • Received : 2012.10.03
  • Accepted : 2013.02.09
  • Published : 2013.08.01
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Abstract

Zenker diverticulum is a rare condition with a reported prevalence of 0.01% to 0.11% in the general population. Challenges that can arise when treating a Zenker diverticulum through flexible endoscopy include maintaining a stable position and avoiding hemorrhage or perforation. Nevertheless, this approach is associated with less morbidity and a shorter hospital stay than conventional treatment consisting of open surgery or rigid endoscopic treatment with diverticuloscopy. We report a case of transparent cap-assisted flexible endoscopic septoplasty using a needle knife.

젠커게실의 치료는 다양한 방법이 있으며 표준 치료는 정립되지 않았다. 이에 대한 장기간 비교연구가 필요하겠지만 투명 캡을 장착하고, swift 응고 모드로 침형절개도를 이용하여 윤상인두근 절제하는 연성 내시경 치료는 안전하고 효과적인 치료 방법이다. 저자들은 성공적으로 윤상인두근을 절개하여 젠커게실을 치료한 증례를 문헌고찰과 함께 보고한다.

Keywords

References

  1. Van Overbeek JJ. Pathogenesis and methods of treatment of Zenker's diverticulum. Ann Otol Rhinol Laryngol 2003;112: 583-593. https://doi.org/10.1177/000348940311200703
  2. Aly A, Devitt PG, Jamieson GG. Evolution of surgical treatment for pharyngeal pouch. Br J Surg 2004;91: 657-664. https://doi.org/10.1002/bjs.4572
  3. Zaninotto G, Narne S, Costantini M, et al. Tailored approach to Zenker's diverticula. Surg Endosc 2003;17:129-133. https://doi.org/10.1007/s00464-002-8806-x
  4. Repici A, Pagano N, Fumagalli U, et al. Transoral treatment of Zenker diverticulum: flexible endoscopy versus endoscopic stapling: a retrospective comparison of outcomes. Dis Esophagus 2011;24:235-239. https://doi.org/10.1111/j.1442-2050.2010.01143.x
  5. Watemberg S, Landau O, Avrahami R. Zenker's diverticulum: reappraisal. Am J Gastroenterol 1996;91:1494-1498.
  6. Acharya A, Jennings S, Douglas S, Mirza S, Beasley N. Carcinoma arising in a pharyngeal pouch previously treated by endoscopic stapling. Laryngoscope 2006;116:1043-1045.
  7. Sen P, Kumar G, Bhattacharyya AK. Pharyngeal pouch: associations and complications. Eur Arch Otorhinolaryngol 2006;263:463-468. https://doi.org/10.1007/s00405-005-1036-9
  8. Ishioka S, Sakai P, Maluf Filho F, Melo JM. Endoscopic incision of Zenker's diverticula. Endoscopy 1995;27:433-437. https://doi.org/10.1055/s-2007-1005736
  9. Sakai P, Ishioka S, Maluf-Filho F, Chaves D, Moura EG. Endoscopic treatment of Zenker's diverticulum with an oblique-end hood attached to the endoscope. Gastrointest Endosc 2001;54:760-763. https://doi.org/10.1067/mge.2001.119606
  10. Manner H, May A, Faerber M, Rabenstein T, Ell C. Safety and efficacy of a new high power argon plasma coagulation system (hp-APC) in lesions of the upper gastrointestinal tract. Dig liver Dis 2006;38:471-478. https://doi.org/10.1016/j.dld.2006.03.022