Naše zkušenosti s chirurgickou léčbou Zenkerova divertiklu

Our Experience in Surgical Therapy of Zenker’s Diverticulum

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.