TY - JOUR
T1 - Tailored approach to Zenker's diverticula
AU - Zaninotto, G.
AU - Narne, S.
AU - Costantini, M.
AU - Molena, D.
AU - Cutrone, C.
AU - Portale, G.
AU - Costantino, M.
AU - Rizzetto, C.
AU - Basili, U.
AU - Ancona, E.
PY - 2003/1
Y1 - 2003/1
N2 - Background: Zenker's diverticula (ZD) can be treated by diverticulostomy or open surgery (upper esophageal sphincter myotomy and diverticulectomy or diverticulopexy). The aim of this study was to compare the outcome of the two alternative treatments. Methods: Fifty eight patients were scored for symptoms and upper esophageal sphincter (UES) pressure; relaxations and intrabolus pressures were recorded by manometry. Treatment depended on operative risk and ZD size. Twenty-four patients with high surgical risk and/or a <3-cm or > 5-cm pouch underwent diverticulostomy; the other 34 had open surgery. Results: Mortality was nil. Five patients had postoperative complications after open surgery (p <0.05). Hospital stay was shorter after diverticulostomy (p <0.001). Follow-up (41 months; range, 1-101) was obtained in 53 patients. Postoperative manometry showed a UES pressure reduction, improved UES relaxation, and lower intrabolus pressure in both groups (p <0.05). In the diverticulostomy group, three patients complained of severe dysphagia. vs none in the open surgery group (p <0.05). Conclusion: Diverticulostomy is safe, quick, and effective for most patients with medium-sized ZD, but open surgery offers better long-term results and should be recommended for younger, healthy patients with small or very large diverticula.
AB - Background: Zenker's diverticula (ZD) can be treated by diverticulostomy or open surgery (upper esophageal sphincter myotomy and diverticulectomy or diverticulopexy). The aim of this study was to compare the outcome of the two alternative treatments. Methods: Fifty eight patients were scored for symptoms and upper esophageal sphincter (UES) pressure; relaxations and intrabolus pressures were recorded by manometry. Treatment depended on operative risk and ZD size. Twenty-four patients with high surgical risk and/or a <3-cm or > 5-cm pouch underwent diverticulostomy; the other 34 had open surgery. Results: Mortality was nil. Five patients had postoperative complications after open surgery (p <0.05). Hospital stay was shorter after diverticulostomy (p <0.001). Follow-up (41 months; range, 1-101) was obtained in 53 patients. Postoperative manometry showed a UES pressure reduction, improved UES relaxation, and lower intrabolus pressure in both groups (p <0.05). In the diverticulostomy group, three patients complained of severe dysphagia. vs none in the open surgery group (p <0.05). Conclusion: Diverticulostomy is safe, quick, and effective for most patients with medium-sized ZD, but open surgery offers better long-term results and should be recommended for younger, healthy patients with small or very large diverticula.
KW - Endoscopic diverticulostomy
KW - Esophagus
KW - Pharynx
KW - Upper esophageal sphincter myotomy
KW - Zenker's diverticula
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U2 - 10.1007/s00464-002-8806-x
DO - 10.1007/s00464-002-8806-x
M3 - Article
C2 - 12370775
AN - SCOPUS:0037267056
SN - 0930-2794
VL - 17
SP - 129
EP - 133
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
IS - 1
ER -