Carbon dioxide laser endoscopic diverticulotomy for Zenker's diverticulum: results and complications in a consecutive series of 40 patients.
BACKGROUND
Numerous studies regarding CO2 laser endoscopic diverticulotomy for the treatment of Zenker's diverticulum exist. They show differences in complications, hospitalization time and postoperative treatment.


OBJECTIVE
We report our experiences and work out recommendations for postoperative care.


METHODS
All charts of patients who were treated for Zenker's diverticulum at the University Department of Otolaryngology, Cologne, Germany, between 1983 and 2003, were reviewed retrospectively.


RESULTS
The median age was 58 years. Postoperatively, patients were fed nonorally and received postoperative antibiotic treatment. One patient developed mediastinitis and 3 patients a rise in body temperature. A control radiography disclosed pharyngeal leakages in 3 patients. Overall morbidity averaged 10%.


CONCLUSIONS
To avoid severe complications we recommend postoperative antibiotic treatment and parenteral feeding. In comparison to the stapler-assisted technique the use of the CO2 laser allows a good view at the diverticular wall throughout the procedure. The transcervical technique should be reserved for cases of anatomic abnormalities or for complicated revision surgeries.
Helmstaedter
Victor
V
Department of Otolaryngology-Head and Neck Surgery, University of Cologne, Cologne, Germany. victor.helmstaedter@uni-koeln.de
Engel
Alexander
A
Huttenbrink
Karl-Bernd
KB
Guntinas-Lichius
Orlando
O
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004867:Equipment Design; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D008480:Mediastinitis / Q000188:drug therapy / Q000209:etiology; D008875:Middle Aged; D010288:Parenteral Nutrition; D010614:Pharynx / Q000000981:diagnostic imaging; D011182:Postoperative Care; D011184:Postoperative Period; D011859:Radiography; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000473:pathology / Q000601:surgery*
D000900:Anti-Bacterial Agents