![]() ![]() The technique should be considered safe, expedient, and effective, particularly in patients with existing comorbidities. This was due to weakness in the inferior pharyngeal constrictor and/or an abnormal timing of the peristalsis whereby contraction of the cricopharyngeus occurred before peristalsis in the inferior pharyngeal constrictor had. Our results compare favorably with those of external approaches. In 11 patients there was some retention of barium proximal to the cricopharyngeus after the passage of the barium bolus. Complications in order of occurrence were pneumomediastinum (4 patients), urinary tract infection (2), upper respiratory tract infection (2), and lip laceration (1). Thirty-seven of 40 patients, including 3 whose previous external procedure was not successful, returned to a regular diet, reported no regurgitation and were satisfied with the procedure. The mean size of the diverticula was 4.1 cm, mean surgery time was 41 minutes, and mean hospital stay was 4.5 days. We reviewed the results of 40 endoscopic diverticulotomy patients, ranging in age from 46 to 88 years, many of whom had significant existing comorbidities. Endoscopic diverticulotomy requires division of the cricopharyngeus and the common wall between the esophagus and diverticulum, a technique popularized by Dohlman. ![]() Treatment is directed toward correcting the underlying sphincter dysfunction and managing the diverticulum. The cause of these acquired diverticula is controversial, although most likely it is related to cricopharyngeus muscle dysfunction. Pharyngoesophageal diverticula, first described in 1769, occur in an area of natural weakness between the inferior pharyngeal constrictor muscles of the pharynx and the cricopharyngeus muscle.
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