Our Experience in Surgical Therapy of Zenker’s Diverticulum
Pellant A.1,2, Chrobok V.1, Spitzer D.3
Klinika ORL a chirurgie hlavy a krku, Krajská nemocnice Pardubice, přednosta prof. MUDr. A. Pellant, DrSc.1 Ústav zdravotnických studií Univerzity Pardubice, ředitel prof. MUDr. A. Pellant, DrSc.2 Radiodiagnostické oddělení, Krajská nemocnice Pardubice, přednosta prim. MUDr. D. Spitzer3 |
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Summary:
The problems and especially the surgical treatment of Zenker’s diverticulum attract continuous
attention. In contrast to stimulating news on endoscopic technique, which points out a shorter duration
of the intervention itself as well as the stay in hospital, low risk of complications and easy subsequent
treatment of the patient in overcoming the problems, contributions referring to surgical treatment of
Zenker’s diverticulum by external approach are still relevant. The aim of this study was to present the
authors’ own experience in surgical therapy of Zenker’s diverticulum in 17 symptomatic patients operated
on in the period of 1st July 1996 to 31st December 2003. In 18 operations (one patient needed to be reoperated
on) performed in all patients by external approach, the diverticulectomy was followed by closure
of the mucous defect by a suture (by Vicryl) in six cases and the resection of diverticulum was performed
without opening of the swallowing pathways by means of linear stapler. In the postoperative course
the authors observed in three patients operated on a transient paralysis of recurrent nerve at the
beginning of the observed period. In one of the patient a hypopharyngeal fistula with zmphysema on the
neck developed in another patient there was healing of the wound per secundum. In 14 patients, who presented
themselves to control examination within the time lapse of 18–96 months after the operation, they
reported effective disappearance of the original complaints and unequivocal satisfaction with the performed
operation. In spite of the favorable evaluation the authors refer to possible discrepancies between
long-term subjective positive postoperative evaluation by the patient and the X-ray examination of the
swallowing act.
Key words:
Zenker’s diverticulum, surgical therapy, linear stapler.
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