Tailored approach to Zenker's diverticula

G. Zaninotto, S. Narne, M. Costantini, D. Molena, C. Cutrone, G. Portale, M. Costantino, C. Rizzetto, U. Basili, E. Ancona

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)129-133
Number of pages5
JournalSurgical Endoscopy and Other Interventional Techniques
Volume17
Issue number1
DOIs
StatePublished - Jan 2003
Externally publishedYes

Keywords

  • Endoscopic diverticulostomy
  • Esophagus
  • Pharynx
  • Upper esophageal sphincter myotomy
  • Zenker's diverticula

ASJC Scopus subject areas

  • Surgery

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