Tringali S, Pierrillas P, Céruse P, Dubreuil C
[Endoscopic staple diverticulostomy for Zenker's diverticulum.] [JOURNAL ARTICLE]
Ann Otolaryngol Chir Cervicofac 2008 May 15.
OBJECTIVE: Retrospective study to evaluate the efficacy and safety of endoscopic stapled diverticulotomy of patients with Zenker's diverticulum.
METHODS: Twenty-two patients with Zenker's diverticulum were evaluated. All patients had a preoperative barium swallow, which confirmed the Zenker diverticulum. SURGICAL
PROCEDURE: Patients underwent an attempted endoscopic resection of the Zenker diverticulum using the endoscopic stapling technique. If unsuccessful, an open approach was then taken. All patients were seen in follow-up within one and then at six months after surgery and had a barium swallow during the first month.
RESULTS: The patient's mean age was 74 years. The operation lasted a mean of 20minutes. Conversion to open surgery was required in five patients, which lasted a mean 20minutes. No postoperative morbidity or mortality was recorded. In two patients with a small diverticulum (2cm), persistent discomfort with no dysphagia or regurgitation was noted. The barium swallow demonstrated a persistent diverticulum without a neck.
CONCLUSION: Endoscopic staple diverticulotomy is an excellent first-intention method to surgically correct Zenker's diverticulum in many patients. It is a technique with a significantly shorter operative time, hospital stay, time to resumption of oral feeding and lower mortality and fewer morbidity complications.
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