gms | German Medical Science

76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 08.05.2005, Erfurt

Endoscopic diverticulotomy – first choice in the treatment of Zenker`s diverticulum

Meeting Abstract

Suche in Medline nach

  • corresponding author Michael Koch - Klinik für HNO-Heilkunde, Hals- und Kopf-Chirurgie, Erlangen
  • author Zenk Johannes - Klinik für HNO-Heilkunde, Hals- und Kopf-Chirurgie, Erlangen
  • Oliver Müller - Klinik für HNO-Heilkunde, Hals- und Kopf-Chirurgie, Erlangen
  • author Iro Heinrich - Klinik für HNO-Heilkunde, Hals- und Kopf-Chirurgie, Erlangen

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno062

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2005/05hno043.shtml

Veröffentlicht: 22. September 2005

© 2005 Koch et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Endoscopic treatment of Zenker´s diverticulum has been established, but is not favored in all centers as treatment of first choice. Higher recurrence rates and worse long-time results are disadvantages, which had been attributed to endoscopic treatment. There are no standards in indications or limitations for this minimal invasive technique.

Patients and Methods: Between 1992 and 2003 93 patients were treated in the department of ENT, Head and Neck Surgery of the University of Erlangen. Age ranged from 40 to 96 years (mean 67). 38 of the patients were treated by transcervical approach (TA) and 55 were by endoscopic diverticulotomy using a CO2-laser (ED).

Results: In 36.6 % of the cases because of contraindications decision to perform a TA was made intraoperatively. Mean time for operation was reduced in endoscopic treatment (52 vs. 119 min. ; p=0.001). Complication rate also was significantly lower after endoscopic diverticulotomy (9.1 % ED vs. 23.7 % TA; p=0.05). Mortality rate was 0 %. Recurrences occurred after ED in of the cases 7.2 % compared to 2.6 % after TA (no significant difference). Four patients (7.3 %) had a second operation (all after ED: 1 case once again ED, 3 cases TA). Success rate (significantly reduced or no complaints reported by the patient) was 94.5 % after ED and 97.4 % after TA.

Conclusions: If there are no contraindications endoscopic diverticulotomy seems to be the treatment of choice in Zenker´s diverticulum. If compared to the transcervical approach the operation time was reduced and the rate of complications was lower. Recurrence rate and success rate were not different in both procedures. Nevertheless, if one considers the frequency of the transcervical approach in our patients, it further seems to be an important alternative and is indicated in cases, in whom endoscopic procedure is impossible or contraindicated.