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
.