Zenker's diverticulum treated by the endoscopic stapling technique.

The objective of the present study is to determine whether the endoscopic stapling technique for the treatment of Zenker's diverticulum provides a relief of symptoms and an acceptably low number of complications. Previous studies have indicated that endoscopic stapling of the common wall between the oesophagus and the diverticulum is a safe and effective method that has a low complication rate and only necessitates a few days of hospitalization. To the present only a few investigations including a limited number of patients have reported the clinical outcome with regard to relief of symptoms and degree of satisfaction in a group of patients treated with this new approach. Twenty-three consecutive patients with Zenker's diverticulum treated with endoscopic staple-assisted oesophagodiverticulotomy were investigated. The median age was 70 years and the median observation time was 12 months. All patients but one (96%), reported significant relief of symptoms and 76% had no symptoms at all at the time of follow-up. In one patient, a postoperative episode of uncomplicated fever occurred, which was managed successfully with gastric tube and antibiotics. Most patients resumed oral intake of fluids and foods within the first postoperative day. The high degree of patient satisfaction, the low rate of complications and the few recurrences of symptoms reported in the present study indicate that the endoscopic stapling technique is an efficient and reliable treatment for Zenker's diverticulum.