Endoscopic staple-assisted esophagodiverticulostomy: An excellent treatment of choice for Zenker's diverticulum

Objectives: The objectives of the present study are to review the technique of endoscopic staple-assisted esophagodiverticulostomy (ESED) for the trea tment of Zenker's diverticulum and to describe our experience and modificat ions with ESED and the advantages of ESED over previous treatments of Zenke r's diverticulum, Study Design: Retrospective review of 74 cases of ESED pe rformed for the treatment of Zenker's diverticulum, Methods: Patient's reco rds were retrospectively reviewed and tabulated for age, sex, size of diver ticulum, symptoms, duration of symptoms, operative time, length of postoper ative hospital stay, oral intake, complications, and relief of symptoms, Re sults: The senior author (R.L.S.) previously reported results in 36 cases o f ESED performed in 34 patients with Zenker's diverticulum, We have perform ed an additional 38 cases of ESED in 37 patients between March 1997 and Aug ust 1999, The rate of success of ESED was similar between the two series. T he average perioperative time, time until oral intake, and length of postop erative hospital stay decreased in the second series. Overall, there were n o mortalities and few complications with ESED, Compared with other forms of treatment of Zenker's diverticulum, such as Dohlman's procedure, diverticu lectomy, and diverticulopexy, ESED has a similar rate of success, decreased perioperative time, decreased convalescence, and decreased mortality and c omplications, Conclusions: Cost-effectiveness, safety, and efficacy of ESED offer new advantages over previously used treatments for Zenker's divertic ulum, These results continue to support the use of ESED as the initial trea tment of choice for patients with Zenker's diverticulum.