Endoscopic diverticulotomy for the treatment of Zenker's diverticulum

Results in 102 patients with staple-assisted endoscopy

Surendra Narne, Cesare Cutrone, Barbara Chella, Luigi Bonavina, Alberto Peracchia

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Endoscopic diverticulotomy for the treatment of Zenker's diverticulum has been reported infrequently in the literature and has engendered considerable controversy. Between March 1992 and September 1996, we attempted to treat 102 patients with endoscopic treatment for pharyngoesophageal diverticula. In 98 patients, the endoscopic surgery was successfully completed. Conversion to open surgery was required in 4 patients (3.92%). One cartridge of staples in 16 patients (16.32%), 2 cartridges in 78 patients (79.59%), and 3 cartridges in 4 patients (4.08%) were used, according to the size of the diverticulum; the median duration of the procedure was 20 minutes (10 to 60 minutes). No postoperative morbidity or mortality was recorded. Oral feeding was started following radiologic control after a median of 2 days; the median hospital stay was 4 days. The median follow-up is 16 months (1 to 45 months). Four patients operated on before the introduction of the modified stapler showed a persistent diverticular pouch: 3 underwent repeat endoscopic operation, and 1 underwent conventional open surgery. All treated patients are asymptomatic. Manometric study performed in 15 patients showed a significant reduction of basal upper esophageal sphincter pressure compared to preoperative data (48.30 ± 21.74 versus 29.38 ± 5.68 mm Hg; p <.01). We therefore recommend endoscopic diverticulotomy, considering that the procedure is relatively safe and effective, with minimal patient discomfort, and the results are equal to those of the external approach. This procedure offers the advantages of short hospitalization, rapid convalescence, brief operative time, absence of skin incision, predictable resolution of symptoms, and reduced morbidity.

Original languageEnglish
Pages (from-to)810-815
Number of pages6
JournalAnnals of Otology, Rhinology and Laryngology
Volume108
Issue number8
Publication statusPublished - 1999

Fingerprint

Zenker Diverticulum
Endoscopy
Therapeutics
Upper Esophageal Sphincter
Conversion to Open Surgery
Morbidity
Diverticulum
Operative Time
Length of Stay
Hospitalization

Keywords

  • Endoscopic diverticulotomy
  • Pharyngoesophageal diverticulum
  • Zenker's diverticulum

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Endoscopic diverticulotomy for the treatment of Zenker's diverticulum : Results in 102 patients with staple-assisted endoscopy. / Narne, Surendra; Cutrone, Cesare; Chella, Barbara; Bonavina, Luigi; Peracchia, Alberto.

In: Annals of Otology, Rhinology and Laryngology, Vol. 108, No. 8, 1999, p. 810-815.

Research output: Contribution to journalArticle

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