Functional results in endoscopic Zenker's diverticulum surgery.
OBJECTIVE
The main objective of this retrospective study was to assess functional results in endoscopic Zenker's diverticulum surgery. The secondary objectives were to assess safety, identify recurrence risk factors, and determine optimal management of recurrence.


METHODS
From 2000 to 2014, 50 patients underwent endoscopic surgery for marsupialization of Zenker's diverticulum. Regurgitation and dysphagia were assessed on the FOIS scale, pre- and post-operatively. Recurrences and complications rates were determined retrospectively at a minimum 18 months' follow-up.


RESULTS
Regurgitation and dysphagia improved in respectively 96% and 86% of patients. There was a 12% rate of complications, mostly minor. Mean hospital stay and time to return to oral feeding were 2.0 and 1.3 days respectively. Nine patients (18%) showed recurrence of symptoms, requiring revision surgery at a mean 2.7 years, performed endoscopically in the majority of cases. Only one recurrence risk factor was identified: small diverticulum size.


CONCLUSIONS
Endoscopic Zenker's diverticulum surgery provided functional improvement in most cases. Safe and effective, it is currently the treatment of choice for Zenker's diverticulum.
Service ORL-CCF, CHU Gabriel Montpied, 58 Rue Montalembert, Clermont-Ferrand, France. Electronic address: hermes.alex@hotmail.fr.
A
A
Dissard
Service ORL-CCF, CHU Gabriel Montpied, 58 Rue Montalembert, Clermont-Ferrand, France.
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L
Gilain
Service ORL-CCF, CHU Gabriel Montpied, 58 Rue Montalembert, Clermont-Ferrand, France.
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R
Pastourel
Service ORL-CCF, CHU Gabriel Montpied, 58 Rue Montalembert, Clermont-Ferrand, France.
T
T
Mom
Service ORL-CCF, CHU Gabriel Montpied, 58 Rue Montalembert, Clermont-Ferrand, France.
N
N
Saroul
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000601:surgery*
CO(2) laser; Endoscopic diverticulotomy; Stapler; Transmucosal/extramucosal myotomy of the superior esophageal sphincter; Zenker's diverticulum