Open diverticulectomy and cricopharyngotomy for symptomatic Zenker’s diverticulum after endoscopic diverticuloesophagostomy

Abstract

Two of the accepted treatments for symptomatic Zenker’s diverticula are open resection of the diverticulum with cricopharyngotomy and transoral, endoscopic diverticuloesophagostomy with cricopharyngotomy. We report our experience with open surgical resection of the diverticulum with repeat cricopharyngotomy in patients with persistent symptoms after endoscopic diverticuloesophagostomy. This is a retrospective review of patients who underwent open surgical resection of the diverticulum, with repeat cricopharyngotomy in patients with persistent symptoms after endoscopic diverticuloesophagostomy. Medical records were reviewed for demographics, surgical detail, short-term complications, and symptomatic outcomes. Four patients underwent open resection of a Zenker’s diverticulum with repeat cricopharyngotomy. There were two men and two women, with a mean age of 77.5 years. The mean operative time was 56 minutes and median length of stay was two days. All patients had improvement in dysphagia. Surgical diverticulectomy with cricopharyngotomy after failed endoscopic diverticuloesophagostomy is a technically challenging operation. However, symptomatic improvement can be achieved.