Carbon Dioxide Laser Endoscopic Diverticulotomy for Zenker's Diverticulum: Results and Complications in a Consecutive Series of 40 Patients

Background: Numerous studies regarding CO2 laser endoscopic diverticulotomy for the treatment of Zenker's diverticulum exist. They show differences in complications, hospitalization time and postoperative treatment. Objectives: We report our experiences and work out recommendations for postoperative care. Methods: All charts of patients who were treated for Zenker's diverticulum at the University Department of Otolaryngology, Cologne, Germany, between 1983 and 2003, were reviewed retrospectively. Results: The median age was 58 years. Postoperatively, patients were fed nonorally and received postoperative antibiotic treatment. One patient developed mediastinitis and 3 patients a rise in body temperature. A control radiography disclosed pharyngeal leakages in 3 patients. Overall morbidity averaged 10%. Conclusion: To avoid severe complications we recommend postoperative antibiotic treatment and parenteral feeding. In comparison to the stapler-assisted technique the use of the CO2 laser allows a good view at the diverticular wall throughout the procedure. The transcervical technique should be reserved for cases of anatomic abnormalities or for complicated revision surgeries. Copyright (c) 2008 S. Karger AG, Basel