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Purpose <p>Killian–Jamieson diverticulum (KJD), first described by Ekberg and Nylander in 1983, is a&#xa0;rare condition with an incidence rate one-fourth of that of Zenker’s diverticulum. We offered a&#xa0;novel transoral endoscopic approach using carbon dioxide (CO<sub>2</sub>) laser cauterization for diverticulotomy. We expected this approach to be more time efficient than the transcervical approach due to the avoidance of recurrent laryngeal nerve dissection.</p> Methods <p>In this retrospective review study spanning from June 2013 to June 2021, we enrolled 13&#xa0;patients with KJD diagnosed at the Department of Shin Kong Wu Ho-Su Memorial Hospital. With the assistance of a&#xa0;microscope-mounted micromanipulator, a&#xa0;continuous-mode 4‑watt CO<sub>2</sub> laser was used for diverticulotomy. The Eating Assessment Tool-10 (EAT-10) was performed before surgery and 2&#xa0;months after surgery.</p> Results <p>The mean age of the participants was 53&#xa0;years. The average hospital stay was 2.9&#xa0;days, and the average operation time was 59 min. We proceeded with swallowing therapy after the operation and used EAT-10 for evaluation after a&#xa0;2-month interval. We observed a&#xa0;significant difference in the average EAT-10 score, decreasing from 11.46 to 4.77 (<i>p</i> &lt; 0.01).</p> Conclusion <p>Killian–Jamieson diverticulum may cause dysphagia and malnutrition in patients due to the resulting anatomical deformities. In our study, we demonstrated the safety and efficacy of the rigid endoscopic CO<sub>2</sub> laser diverticulotomy approach, with no obvious complications observed. It is a&#xa0;promising treatment alternative for patients who prefer a&#xa0;minimally invasive approach to an open procedure. Larger prospective studies should be performed to compare this novel endoscopic approach to the open transcervical approach in KJD management.</p>

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Rigid endoscopic laser diverticulotomy for treating lateral pharyngoesophageal diverticulum

  • 期刊论文

  • 发表日期：

    2025年7月25日

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  • Yu-Xiang Kuo,
  • Hsing-Mei Wu,
  • Tzu-Hsuan Luo,
  • Tzu-I Wu,
  • Chia-Jung Lee

摘要

Purpose

Killian–Jamieson diverticulum (KJD), first described by Ekberg and Nylander in 1983, is a rare condition with an incidence rate one-fourth of that of Zenker’s diverticulum. We offered a novel transoral endoscopic approach using carbon dioxide (CO2) laser cauterization for diverticulotomy. We expected this approach to be more time efficient than the transcervical approach due to the avoidance of recurrent laryngeal nerve dissection.

Methods

In this retrospective review study spanning from June 2013 to June 2021, we enrolled 13 patients with KJD diagnosed at the Department of Shin Kong Wu Ho-Su Memorial Hospital. With the assistance of a microscope-mounted micromanipulator, a continuous-mode 4‑watt CO2 laser was used for diverticulotomy. The Eating Assessment Tool-10 (EAT-10) was performed before surgery and 2 months after surgery.

Results

The mean age of the participants was 53 years. The average hospital stay was 2.9 days, and the average operation time was 59 min. We proceeded with swallowing therapy after the operation and used EAT-10 for evaluation after a 2-month interval. We observed a significant difference in the average EAT-10 score, decreasing from 11.46 to 4.77 (p < 0.01).

Conclusion

Killian–Jamieson diverticulum may cause dysphagia and malnutrition in patients due to the resulting anatomical deformities. In our study, we demonstrated the safety and efficacy of the rigid endoscopic CO2 laser diverticulotomy approach, with no obvious complications observed. It is a promising treatment alternative for patients who prefer a minimally invasive approach to an open procedure. Larger prospective studies should be performed to compare this novel endoscopic approach to the open transcervical approach in KJD management.