Zenker's diverticulum treated with submucosal tunneling endoscopic septum division surgery: Two case reports

INTRODUCTION: Zenker's diverticulum (ZD) refers to a pouch-like structure similar to the esophageal lumen formed from the herniation of the esophageal mucosa; this structure makes it difficult for food to pass through the esophagus to the stomach. The development of endoscopic technology has made minimally invasive surgical treatments for ZD possible. PATIENT CONCERNS: A female 72-year-old patient was admitted to our hospital due to recurrent dysphagia for more than 5 years. A 62-year-old female patient underwent a gastroscopic examination due to recurrent dysphagia for 10 years and aggravated dysphagia accompanied by bad breath for 1 year. DIAGNOSIS: A significant diverticulum with food residue at the entrance of the esophagus was found on gastroscopy in both cases. INTERVENTIONS: After completing a relevant examination and excluding surgical contraindications, both patients underwent submucosal tunneling endoscopic septum division. OUTCOMES: Both patients were discharged after symptoms alleviated on postoperative day 4. A 3-month follow-up gastroscopy showed the disappearance of the diverticulum and recovery of the esophageal anatomical structure. No symptom relapse was found at the 6-month follow-up assessment. CONCLUSION: Submucosal tunneling endoscopic septum division has become the most common minimally invasive treatment option. It is efficient and safe for relieving symptomatic ZD in the short term.