Surgery of Zenker’s diverticulum; Single center exper
Surgery of Zenker’s diverticulum; Single center exper
Aim: Zenker’s diverticulum is the most frequently seen esophageal diverticula. Zenker’s diverticulum should be considered that the patients have symptoms such as dysphagia, regurgitation of undigested food, turbulence sound, chronic cough, weight loss, and halytosis. We aimed to evaluate the patients whom underwent diverticulectomy and cricomyotomy due to Zenker’s diverticulum located in the proximal esophagus in terms of demographic features, operative type, postoperative complications and recurrence.Material and Methods: Between January 2013 and 2018, 10 patients (9 female and 1 male) who underwent surgery due to dysphagia because of the Zenker’s diverticulum were evaluated retrospectively. The median age of the patients was 67.5 (47-77). Because of the dysphagia was the most frequently symptom, initial evaluation was performed with upper gastrointestinal system endoscopy (UGSE). All patients were examined barium esophagography and some patients with tomography.Dysphagia levels of the patients were evaluated before and after the operation. Patients were followed-by endoscopy 1 and 6th. months after surgery.Results: Complications, mortality and morbidity were not seen in postoperative early and late periods. Only 1 patient had recurrence. When compared the dysphasia scores of the patients before and after surgery were significantly improved after operation.Conclusion: Diverticulectomy and cricomyotomy operations in Zenker’s diverticulum are effective and safe procedures.
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- Ludlow A. A case of obstructed deglutition from a preternatural dilatation of and bag formed in the pharynx. Med Observ Inq Soc Phys 1769;3:85-101.
- Zenker FA, von Ziemssen H. Krankheiten des Oesophagus. In: von Ziemsen H (ed) Handbuch der Speciellen Pathologie und Therapie Vogel, Leipzig 1874;7:1-87.
- Killian G. Ueber den Mund der Speiseroehre. Zeitschrift fur Ohrenheilkunde und fuer die Krankheiten der Luftwege 1908;55:1-41.
- Anagiotos A, Preuss SF, Koebke J. Morphometric and anthropometric analysis of Killian’s triangle. Laryngoscope 2010;1201082-8.
- Cook IJ, Gabb M, Panagopoulos V, et al. Pharyngeal (Zenker’s ) diverticulum is a disorder of upper esophageal sphincter opening. Gastroenterology 1992;103:1229-35.
- Maran AG, Wilson JA, Al Muhanna AH. Pharyngeal diverticula. Clin Otolaryngol Allied Sci 1986;11:219-25.
- Westrin KM, Ergun S, Carlsöö B. Zenker’s diverticulum - a historical review and trends in therapy. Acta Otolaryngol 1996;116:351-60.
- Bowdler DA. Pharyngeal pouches. In: Kerr A, ed. Scott Brown’s Textbook of Otorhinolaryngology. 6th ed. Oxford: Butterworth-Heinmann 1997:1-21.
- Teke Z, Bostancı EB, Aksoy E, et al. Surgical treatment of Zenker’s diverticulum. Turkish journal of Sugery 2010;26:73-8.
- Resouly A, Braat J, Jackson A, et al. Pharyngeal pouch: link with reflux and oesophageal dysmotility. Clinical Otolaryngology and Allied Sciences 1994;19:241-2.
- Rizzetto C, Zaninotto G, Costantini M, et al. Zenker’s diverticula: feasibility of a tailored approach based on diverticulum size. J Gastrointest Surg 2008;12:2057-64.
- Yuan Y, Zhao YF, Hu Y, et al. Surgical Treatment of Zenker’s Diverticulum Dig Surg 2013;30:207-18.
- Lerut T, van Raemdonck D, Guelinckx P, et al. Zenker’s diverticulum: is a myotomy of the cricopharyngeus useful? How long should it be? Hepatogastroenterology 1992;39:127-31.
- Skinner KA, Zuckerbraun L. Recurrent Zenker’s diverticulum.Treatment with crycopharyngeal myotomy. Am Surg 1998;64:192-5.
- Payne WS. The treatment of pharyngoesophageal diverticulum: the simple and complex. Hepatogastroenterology 1992;39:109-14.
- Colombo-Benkmann M, Unruh V, Krieglstein C, et al. Cricopharyngeal myotomy in the treatment of Zenker’s diverticulum. J Am Coll Surg 2003;196:370-7.
- Dohlman G, Mattsson O. The endoscopic operation for hypopharyngeal diverticula: a roentgencinematographic study. AMA Arch Otoralyngol 1960;71:744-52.
- van Overbeek JJ, Hoeksema PE, Edens ET. Microendoscopic surgery of the hypopharyngeal diverticulum using electrocoagulation or carbon dioxide laser. Ann Otol Rhinol Laryngol 1984;93:34-6.
- Van Overbeek JJ. Meditation on the pathogenesis of hypopharyngeal (Zenker’s) diverticulum and a report of endoscopic treatment in 545 patients. Ann Otol Rhinol Laryngol 1994;103:178-85.
- Bonavina L, Bona D, Abraham M, et al. Long-term results of endosurgical and open surgical approach for Zenker diverticulum. World J Gastroenterol 2007;13:2586-89
- Ozgursoy OB, Salassa JR. Functional and manofluorographic outcomes after transoral endoscopic pharyngoesophageal diverticulostomy. Arch Otolaryngol Head Neck Surg 2010;136:463-7.
- Gutschow CA, Hamoir M, Rombaux P, et al. Management of pharyngoesophageal (Zenker’s) diverticulum: which technique? Ann Thorac Surg 2002;74:1677-82.