Traitement endoscopique des diverticules de Zenker à la pince autosuturante

Objective

Retrospective study to evaluate the efficacy and safety of endoscopic stapled diverticulotomy of patients with Zenker's diverticulum.

Methods

Twenty-two patients with Zenker's diverticulum were evaluated. All patients had a preoperative barium swallow, which confirmed the Zenker diverticulum.

Surgical procedure

Patients underwent an attempted endoscopic resection of the Zenker diverticulum using the endoscopic stapling technique. If unsuccessful, an open approach was then taken. All patients were seen in follow-up within one and then at six months after surgery and had a barium swallow during the first month.

Results

The patient's mean age was 74 years. The operation lasted a mean of 20 minutes. Conversion to open surgery was required in five patients, which lasted a mean 20 minutes. No postoperative morbidity or mortality was recorded. In two patients with a small diverticulum (2 cm), persistent discomfort with no dysphagia or regurgitation was noted. The barium swallow demonstrated a persistent diverticulum without a neck.

Conclusion

Endoscopic staple diverticulotomy is an excellent first-intention method to surgically correct Zenker's diverticulum in many patients. It is a technique with a significantly shorter operative time, hospital stay, time to resumption of oral feeding and lower mortality and fewer morbidity complications.