Optimal treatment for Zenker's diverticulum transcervical approach versus microendoscopic surgery

Although the pulsion diverticulum of hypopharynx was first described by A. Ludlow in 1964, the name of the German pathologist F.A. von Zenker is definitively associated with this diverticulum, probably because he was the first to publish a full description of its clinical and pathological aspects. Later, numerous techniques have been described to surgically treat Zenker's diverticulum. However optimal treatment remains controverseal. Considering transcervical approaches, microendoscopic CO2 laser diverticulotomy offers comparable functional results. Moreover, this procedure offers the advantages of reduced morbidity, is very short-time consuming and requires a short hospitalization. These last issues should be seriously taken in consideration regarding medical cost. Subsequently, we advocate that microendoscopic CO2 laser diverticulotomy should be considered as first-line treatment option for patients suffering of Zenker's diverticulum. (C) 1997, Masson, Paris.