Surgical treatment of Zenker diverticula

Abstract

Zenker diverticula are due to a disorder in the opening of the upper oesophageal sphincter, causing the protrusion of mucosa through the posterior pharyngoesophageal wall. The incidence of Zenker diverticula is estimated between 0.01% and 0.11% and classically occur in males and the elderly. Therapeutic management of the patient with Zenker diverticulum is fundamentally influenced by the presence or absence of symptoms, the size and location of the diverticulum. Operative treatment should be reserved only for symptomatic patients and for large diverticula (>2 cm), in order to improve the quality of life and avoid complications. For many decades, Zenker diverticula was treated with an open surgical approach. Traditionally, surgical management has been the mainstay of treatment, but endoscopic approach has now become accepted as a viable minimally invasive treatment option with a lower rate of complications. The resolution of symptoms with the open approach is estimated in 93–95% of cases and the relapse rate is 2.9%. Compared with endoscopic treatments, the morbidity and mortality rates are higher. In this paper we reviewed the current literature on surgical approach to Zenker’s diverticula in terms of clinical results and