[Our experience with diverticulectomy in symptomatic Zenker's diverticulum]

Abstract

Introduction: The frequency of endoscopic procedures for management of Zenker's diverticulum has increased rapidly in the last years. Endoscopic methods are highly effective. We tried to answer the question whether the development of endoscopic methods means the end of open surgery.

Patients and methods: In this retrospective study 30 patients (11 men, 19 women) with an average age of 70.9 (49-88) years with Zenker's diverticulum (ZD) were included. All patients were treated with an open transcervical approach between October 2000 and July 2005. In all cases the region of ablation of the diverticulum was closed with a primary handmade suture. In two cases an additional myotomy was performed. For evaluation of the long-term results the patients were sent a questionnaire. To objectify the findings, all patients underwent postoperatively an X-ray examination of the esophagus. The literature was searched by PubMed.

Results: 30 patients underwent 32 operations. 91 % of the inquired patients evaluated the operation as successful. An anastomotic leakage was observed in 3 patients, a lesion of the recurrent laryngeal nerve occurred in 2 patients.

Conclusion: Despite the rapid development of endoscopic methods the open surgical approach remains a reliable and minimal invasive solution of ZD with excellent results and low complication rate. In patients that cannot undergo endoscopic procedures the surgical approach represents the only therapeutic option. Therefore surgical training for repairing ZD is also necessary for the future.