2016
DOI: 10.1001/jamaoto.2015.3892
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Zenker Diverticulum—Which Surgical Approach Is Superior?

Abstract: Endoscopic diverticulostomy is a better first-line treatment than open diverticulectomy for Zenker diverticulum.

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Cited by 43 publications
(31 citation statements)
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“…Data from the literature on the size of the diverticular septum are sparse and patients operated trans-orally have relatively small diverticula between 3 and 5 cm with septotomy up to 3 to 4 cm. [ 5 , 7 11 , 13 15 ] We wanted to show that there is still quite a large population of patients who are doubtful candidates for the ED and that alternative open diverticulectomy remains safe, especially in centers that specialize in esophageal surgery. Partial septotomy in diverticula bigger than 5 cm proposed by some surgeons even if results in successful myotomy still fails to completely remove the septum, which in future may require one or more endoscopic interventions.…”
Section: Discussionmentioning
confidence: 99%
“…Data from the literature on the size of the diverticular septum are sparse and patients operated trans-orally have relatively small diverticula between 3 and 5 cm with septotomy up to 3 to 4 cm. [ 5 , 7 11 , 13 15 ] We wanted to show that there is still quite a large population of patients who are doubtful candidates for the ED and that alternative open diverticulectomy remains safe, especially in centers that specialize in esophageal surgery. Partial septotomy in diverticula bigger than 5 cm proposed by some surgeons even if results in successful myotomy still fails to completely remove the septum, which in future may require one or more endoscopic interventions.…”
Section: Discussionmentioning
confidence: 99%
“…The primary treatment modality to improve swallowing function in patients with Zenker's diverticulum is surgery 11,31 . Procedures are often completed in symptomatic patients after years of slow diverticular growth, with the goal of eliminating diverticular bolus retention, as well as improving bolus flow and relieving outflow obstruction 11 .…”
Section: Discussionmentioning
confidence: 99%
“…Table summarises results of the here presented patient population showing the superiority or at least equality in comparison with other reported populations and techniques. Only recently, a comprehensive review on the available literature with focus on endoscopic and external transcervical treatment approaches for ZD was published and entailed an already ongoing debate on the superior treatment option . In the light of the presented data by Verdonck and Morton, it clearly seems surprising that in conclusion external approaches are recommended as superior treatment mainly based on the perception of an failure rate of 18.5% for endoscopic approaches (both MEDCO 2 and ESED together) compared to 4.2% failure reported for external approaches.…”
Section: Discussionmentioning
confidence: 99%
“…Data from 119 patients treated by MEDCO 2 at our department were published, previously . Here, we add 108 patients who were treated alike between 2002 and 2012 and describe perioperative management, complications and long‐term results in the light of the present literature and ongoing debate in comparison with ESED and OTA . With 227 patients, we report on the largest population treated for Zenker's diverticulum by MEDCO 2 at a single medical centre.…”
mentioning
confidence: 99%