Feasibility and outcome of endoscopic staple-assisted esophagodiverticulostomy for Zenker's diverticulum.
OBJECTIVE
Endoscopic staple-assisted esophagodiverticulostomy (ESED) is a newly described method of surgically correcting Zenker's diverticulum. Initial reports on the ease and success of the surgery have been quite enthusiastic, making it seem the procedure of choice. We initiated the procedure in an algorithm of treatment of Zenker's diverticulum, to further explore the feasibility and outcome of this new technique.


METHODS
This is a case series of 23 patients with Zenker's diverticulum who have undergone surgical repair. For each patient, an attempt at ESED was made. If unsuccessful, an open approach was then taken.


RESULTS
Seven of 23 patients (30%) were unable to be treated with ESED because of inability to expose the diverticulum or unfavorable anatomy of the diverticulum itself. Of the remaining 16 patients, ESED was successful in resolving the symptoms of diverticulum in 14 (87%). Two patients (13%) were somewhat improved but had persistent dysphagia. No significant complications occurred. All patients resumed oral diet within the first 24 hours after surgery.


CONCLUSIONS
Esophagodiverticulostomy is an excellent method of surgically correcting Zenker's diverticulum in many patients, but anatomical considerations may prevent its use, making open approaches of continued importance in a surgeon's armamentarium.
Thaler
E R
ER
Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. thaler@mail.med.upenn.edu
Weber
R S
RS
Goldberg
A N
AN
Weinstein
G S
GS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media; D003371:Cough / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D004945:Esophagoscopy / Q000379:methods*; D004946:Esophagostomy / Q000295:instrumentation* / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007826:Laryngismus / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000209:etiology; D017792:Surgical Stapling / Q000295:instrumentation* / Q000379:methods*; D013537:Sutures; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000150:complications / Q000175:diagnosis / Q000601:surgery*
D003287:Contrast Media; D001466:Barium Sulfate