Endoscopic treatment of Zenker's diverticulum

Background: The most important aspect of the surgical management of Zenker' s diverticulum is probably the cricopharyngeal myotomy. Endoscopic divertic ulotomy can be performed with a needle-knife papillotome, which allows simu ltaneous myotomy of the upper esophageal sphincter: Methods: Since 1978, 47 patients (28 men and 19 women 51 to 81 years of age ) underwent endoscopic diverticulotomy. Most patients underwent more than o ne treatment session (mean value 2.2). The procedure was performed with sed ation. Tubes were not used, and oral intake of food was begun the first day after the operation. Results: Forty-five (95.74%) patients had no dysphagia or only occasional, mild dysphagia during the postoperative course. No fistula, no recurrent la ryngeal paralysis, and no deaths occurred. Conclusion: Endoscopic diverticulotomy seems to be a good choice of therapy at least for patients with associated diseases that increase surgical risk .