Experience in the treatment of patients with Zenker’s diverticulum

Written by Stegniy K.V., Matsak V.A., Agapov M.Yu., Shulga I.V., Krekoten A.A., Goncharuk R.A., Sarychev V.A., Soroka A.K., Dmitriev M.O., Dvoynikova E.R.

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Background. Despite more than a century of study to date choice of surgical treatment method criteria of Zenker diverticula are not defined.
Methods. Retrospectively 37 cases with Zenker›s diverticulum were analyzed in Vladivostok clinics from 2007 to 2013. All patients underwent endotracheal anesthesia surgery: traditional diverticulum resection (23 cases), stapled ezofagodiverculostomy (7 cases), and endoscopic ezofagodiverculostomy (7 cases).
Results. The average time of the traditional surgery – 47±16 min (recovery in 100 % of the cases). The average time of stapled ezofagodiverculostomy – 70±22 min. Regurgitation and dysphagia have been preserved in one case, relapses were found in four cases, diverticulitis – in two patients. One patient 3 years after the surgery was diagnosed malignancy residual cavity diverticulum. The average time of endoscopic ezofagodiverculostomy – 62±21 min. Regurgitation and dysphagia persisted in two cases, recurrences are found in two patients.
Conclusions. The gold standard of treatment of Zenker›s diverticulum is surgery. The average performance time of traditional resection of diverticulum is less than that of stapled ezofagodiverculostomy because of using trans-illumination. Patients with severe concomitant diseases, large and giant diverticula is prescribed for relief of dysphagia symptoms the stapled ezofagodiverculostomy.

Links to authors:

K.V. Stegniy1, 2, V.A. Matsak3, M.Yu. Agapov4, I.V. Shulga3, A.A. Krekoten4, R.A. Goncharuk1, 2, V.A. Sarychev4, A.K. Soroka2, M.O. Dmitriev2, E.R. Dvoynikova1, 2
1 Pacific State Medical University (2 Ostryakova Ave. Vladivostok 690950 Russian Federation),
2 Medical Center of far Eastern Federal University (10, Ayaks, Russkiy Island, Vladivostok 690000 Russian Federation),
3 Primorye Regional Clinical Hospital No. 1 (57 Aleutskaya St. Vladivostok 690091 Russian Federation),
4 JSC Russian Railways hospital branch at the Vladivostok station (25 Verkhneportovaya St. Vladivostok 690063 Russian Federation)

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