[Modern treatment options for Zenker's diverticulum: indications and results].
Conventional transcervical therapy of Zenker's diverticulum comprises diverticulectomy, invagination, diverticulopexy and myotomy, which may be combined with the aforementioned methods. Transoral diverticuloesophagostomy is performed by diathermy, lasers or staplers through a rigid esophagoscope, or more recently by diathermy applied via a flexible endoscope. Morbidity of transcervical procedures ranges between 3 (myotomy) and 23 % (diverticulectomy + myotomy). The percentage of patients with at least significantly improved symptoms is 92 % or more, while recurrences occur in 5.7 (diverticulectomy alone) to 21 % (invagination). Transoral procedures have a morbidity of 9 (stapler) to 26 % (Laser), while symptoms improve in 91 (diathermy through rigid esophagoscope) to 99 % (diathermy via flexible endoscope), however in up to 64 % of patients reoperations are necessary. Small diverticula (Brombart I/II) can be treated by diverticulectomy (with/without myotomy) or flexible endoscopy, larger diverticula in general by all methods. Patients younger than 60 years should undergo diverticulectomy, elderly multimorbid patients should be treated by transoral procedures.
Colombo-Benkmann
M
M
Klinik und Poliklinik für Allgemeine Chirurgie, Westfälische-Wilhelms Universität Münster. m.colombo.benkmann@uni-muenster.de
Unruh
V
V
Kocher
T
T
Krieglstein
C
C
Senninger
N
N
D004564:Electrocoagulation; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D006801:Humans; D053685:Laser Therapy; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D013528:Surgical Staplers; D016672:Zenker Diverticulum / Q000175:diagnosis / Q000601:surgery*
Aktuelle Behandlungskonzepte des Zenker-Divertikels--Indikationen und Ergebnisse.