Introduction:

The Zenker pharyngoesophageal diverticulum is a rare disease, affecting elderly patients. The main symptoms are dysphagia, halitosis and weight loss. The flexible endoscope therapy is a suitable alternative with results similar to surgical treatment. Aim: We present our experience in 14 patients with Zenker’s diverticulum.

Material and methods:

Retrospective study from January 1, 2008 to January 1, 2017 reviewing the database in patients with symptomatic Zenker’s diverticulum who underwent endoscopic myotomy. All procedures were performed in our hospital. The most common symptom was dysphagia. Registered with a score of 0-3 (0 without dysphagia, 1 for solids, liquids 2 and 3 spittle).

Results:

Eighteen procedures were performed in 14 patients, 100% had dysphagia score improvement within 30 days. The median follow-up was 24 months. Five patients were followed for at least 12 months and 92.8% had a good evolution. Five diverticula were 3 cm and the rest 5 cm or more. All were subjected to endoscopic cricofaryngomiotomy with a knife needle through a gastroscope. Improvement of dysphagia was immediate in all cases. Reoperation was necessary in four cases (28.5%), with good results in 100%. A patient developed bleeding during the first procedure requiring a successful second intervention the next day. Two patients developed subcutaneous emphysema treated conservatively. There were no perforations or infections.

Conclusions:

The endoscopic treatment is a safe and effective alternative for the management of patients with Zenker’s diverticulum.

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