Carbon dioxide laser endoscopic treatment for Zenker´s diverticulum: Experiences in a consecutive series of 38 patients

Numerous methods or modifications for treatment of Zenker´s diverticula are published. Nowadays the endoluminal, less invasiv techniques are mostly preferred. In literature differences regarding complications, hospitalization time and postoperative management are shown. Our experiences for carbon dioxide laser endoscopic treatment for Zenker´s diverticulum are presented and relevant literature is reviewed.

A retrospective review of all patients with Zenker´s diverticulum treated between February 2014 and February 2019 was performed.

38 patients (25 men, 13 women) in a mean age of 71,4 years (38-89; median:74) were treated by endoscopic diverticulotomy. Duration was 50,2 minutes on average. Postoperative feeding normally was realized via nasogastric tube for ordinary 6,2 days. In three cases oral feeding was allowed postoperatively. During hospitalization on an average of 7 days, patients were treated with an antibiotic medication. A control dynamic contrast radiography to exclude a paraluminate was not performed generally (in 11 cases) before feeding was started. Complications occurred in 3 cases, one mediastinitis, one spontaneously regressive cutaneous emphysema and one pulmonary embolism.

Carbon dioxidelaser endoscopic diverticulotomy is a safe procedure for treatment of Zenker´s diverticulum. In Comparison to the endoscopic stapler-assisted technique, it allows a good view at anatomic conditions. Because of the risk of developing mediastinitis postoperative feeding should be performed with a nasogastral feeding tube and an antibiotic medication should be given.

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Publication History

Article published online:
10 June 2020