What kind of operation is prefered in the treatment of Zenker's diverticula

Aims: The most common used surgical management for Zenker's diverticula is open resection with crycopharingeal myotomy and endoscopic oesophago-diverticulostomy. Authors summarize the indications, contraindications, advantages and disadvantages of these procedures.

Patients and methods: In a five year period 10 patients (5 male, 5 female, mean age of 56,9 years) were treated with Zenker's diverticula. Dysphagia and regurgitation were observed in all patients. Respiratory complications occurred in 4 patients. Seven of them were operated with open and three with endoscopic technique. The mean size of the diverticula was 6,1cm (3–10cm). In the resected group the size of the diverticula was bigger, than in the other group (7,4cm vs. 4,3cm).

Results: The hospital stay was higher in the resected group than in the other group (8,1 vs. 4,6 days). In three cases transitoric dysphagia and in one case suture insufficiency developed after resection of the diverticula. There were no other complications and mortality in this seria.

Conclusions: The advantages of the oesophago-diverticulostomia are shorter operative time and hospital stay, and less morbidity. The authors suggest this method as the first line of surgical therapy in case of Zenker diverticula less than 8 and more than 3cm. The open surgery is preferred in giant diverticulas and if endoscopic surgery is contraindicated.