Results of laser surgery in the treatment of Zenker's diverticulum.

INTRODUCTION: Zenker's diverticulum is an uncommon pathology of the upper oesophageal sphincter whose most frequent symptoms are the association of dysphagia and regurgitation. It is more frequent in advanced ages, and its treatment of choice is surgery in symptomatic cases. METHOD: A retrospective descriptive study was performed of 27 patients operated in the Otorhinolaryngology service of the Hospital Universitario de Cabueñes between 2007 and 2019 using laser endoscopic surgery. RESULTS: 27 patients were operated, 70.4% male and 29.6% female, with a mean age of 67 years (range between 30 and 91). The most frequent symptom at diagnosis was dysphagia. No intraoperative complications were observed. One patient (3.7%) presented post-surgical fever, and another patient (3.7%) had a serious complication due to oesophageal perforation secondary to postsurgical emesis. The median hospital stay was 5 days, and the median oral intake was 4 days. Recurrence was observed in 6 patients (22.2%), 4 (14.8%) requiring a second intervention, which was performed using the same technique. DISCUSSION AND CONCLUSIONS: The surgical treatment of Zenker's diverticulum has advanced in recent decades, with endoscopic treatment currently being the choice. Among the surgical options, endoscopic CO2 laser surgery is an effective and safe alternative, although possible complications must be considered. It is also an effective alternative for the treatment of recurrences.

Resultados de cirugía láser en el tratamiento del divertículo de Zenker / Results of laser surgery in the treatment of Zenker's diverticulum

Introducción: El divertículo de Zenker es una patología infrecuente del esfínter esofágico superior cuya clínica típica es la asociación de disfagia y regurgitación alimentaria. Es más frecuente en edades avanzadas, y su tratamiento de elección es quirúrgico en casos sintomáticos, existiendo diversas técnicas quirúrgicas.MétodoSe realiza un estudio descriptivo retrospectivo de 27 pacientes intervenidos en el Servicio de Otorrinolaringología del Hospital Universitario de Cabueñes entre los años 2007 y 2019 mediante cirugía endoscópica láser.ResultadosSe intervinieron 27 pacientes, un 70,4% varones y un 29,6% mujeres, con una edad media de 67 años (rango entre 30 y 91). El síntoma más frecuente al momento del diagnóstico fue la disfagia. No se observaron complicaciones intraoperatorias. Un paciente (3,7%) presentó fiebre posquirúrgica, y otra paciente (3,7%) una complicación grave por perforación esofágica secundaria a emesis posquirúrgica. La mediana de estancia hospitalaria fue de 5 días, y la del inicio de ingesta oral fue 4 días. Se observó recidiva en 6 pacientes (22,2%), requiriendo una segunda intervención cuatro de ellos (14,8%), que se realizó mediante la misma técnica.Discusión y conclusionesEl tratamiento quirúrgico del divertículo de Zenker ha avanzado en las últimas décadas, siendo actualmente de elección el tratamiento endoscópico. Dentro de las opciones quirúrgicas, la cirugía endoscópica con láser CO2 es una alternativa eficaz y segura, aunque se deben tener en cuenta las posibles complicaciones, en ocasiones de gravedad. Supone también una alternativa eficaz para el tratamiento de las recidivas. (AU)

Introduction: Zenker's diverticulum is an uncommon pathology of the upper oesophageal sphincter whose most frequent symptoms are the association of dysphagia and regurgitation. It is more frequent in advanced ages, and its treatment of choice is surgery in symptomatic cases.MethodA retrospective descriptive study was performed of 27 patients operated in the Otorhinolaryngology service of the Hospital Universitario de Cabueñes between 2007 and 2019 using laser endoscopic surgery.Results27 patients were operated, 70.4% male and 29.6% female, with a mean age of 67 years (range between 30 and 91). The most frequent symptom at diagnosis was dysphagia. No intraoperative complications were observed. One patient (3.7%) presented post-surgical fever, and another patient (3.7%) had a serious complication due to oesophageal perforation secondary to postsurgical emesis. The median hospital stay was 5 days, and the median oral intake was 4 days. Recurrence was observed in 6 patients (22.2%), 4 (14.8%) requiring a second intervention, which was performed using the same technique.Discussion and conclusionsThe surgical treatment of Zenker's diverticulum has advanced in recent decades, with endoscopic treatment currently being the choice. Among the surgical options, endoscopic CO2 laser surgery is an effective and safe alternative, although possible complications must be considered. It is also an effective alternative for the treatment of recurrences. (AU)

Results of laser surgery in the treatment of Zenker's diverticulum. / Resultados de cirugía láser en el tratamiento del divertículo de Zenker.

INTRODUCTION: Zenker's diverticulum is an uncommon pathology of the upper oesophageal sphincter whose most frequent symptoms are the association of dysphagia and regurgitation. It is more frequent in advanced ages, and its treatment of choice is surgery in symptomatic cases. METHOD: A retrospective descriptive study was performed of 27 patients operated in the Otorhinolaryngology service of the Hospital Universitario de Cabueñes between 2007 and 2019 using laser endoscopic surgery. RESULTS: 27 patients were operated, 70.4% male and 29.6% female, with a mean age of 67 years (range between 30 and 91). The most frequent symptom at diagnosis was dysphagia. No intraoperative complications were observed. One patient (3.7%) presented post-surgical fever, and another patient (3.7%) had a serious complication due to oesophageal perforation secondary to postsurgical emesis. The median hospital stay was 5 days, and the median oral intake was 4 days. Recurrence was observed in 6 patients (22.2%), 4 (14.8%) requiring a second intervention, which was performed using the same technique. DISCUSSION AND CONCLUSIONS: The surgical treatment of Zenker's diverticulum has advanced in recent decades, with endoscopic treatment currently being the choice. Among the surgical options, endoscopic CO2 laser surgery is an effective and safe alternative, although possible complications must be considered. It is also an effective alternative for the treatment of recurrences.