Surgical treatment of Zenker's diverticulum
Zafer Teke1, Erdal Birol Bostancı1, Erol Aksoy1, Murat Ulaş1, Tahsin Dalgıç1, Fuat Atalay2, Musa Akoğlu1
1Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Cerrahi Kliniği, Ankara, Türkiye
2Özel Ankara Güven Hastanesi, Gastroenteroloji Cerrahi Departmanı, Ankara, Türkiye
Abstract
Purpose: In this study, we aimed to evaluate surgical outcomes of patients who were operated for Zenker's diverticulum in our clinic.
Patients and Methods: Between 2004 and 2009, 13 patients were operated on for Zenker's diverticulum in our clinic. We evaluated these patients with respect to the variables including age, gender, symptoms duration of symptoms, diagnostic modalities, upper gastrointestinal comorbidities concurrent with Zenker's diverticulum, Brombart stage, associated medical risk factors, ASA score, diverticular size operative technique, operating time, time to oral intake, postoperative complications, length of hospital stay and symptomatic relief.
Results: Thirteen patients, 12 (72.2%) were male and one (27.8%) was female, and their median age was 56 years. Dysphagia odynophagia, weight loss and coughing were common symptoms. The median duration of symptoms was 27 months. According to Brombart classification, 5 patients were in stage III and 8 patients were in stage IV. The median diverticular size was 4.5 cm. Twelve patients (92.3%) underwent diverticulectomy with cricopharyngeal myotomy and one patient (7.7%) diverticulopexy with cricopharyngeal myotomy. One patient (7.7%) suffered from esophageal fistula postoperatively and treated conservatively. The median follow-up period was 47 months. Eleven patients (85%) were symptom-free.
Conclusion: This study demonstrates that diverticulectomy or diverticulopexy with cricopharyngeal myotomy can be performed with acceptable morbidity in surgical treatment of Zenker's diverticulum.
Keywords: diverticulum, pharyngeal diverticula, pharyngoesophageal pulsion diverticulum, upper esophageal sphincter