Carbon dioxide laser endoscopic diverticulotomy for Zenker's diverticulum: results and complications in a consecutive series of 40 patients.

BACKGROUND: Numerous studies regarding CO2 laser endoscopic diverticulotomy for the treatment of Zenker's diverticulum exist. They show differences in complications, hospitalization time and postoperative treatment.

OBJECTIVES: We report our experiences and work out recommendations for postoperative care.

METHODS: All charts of patients who were treated for Zenker's diverticulum at the University Department of Otolaryngology, Cologne, Germany, between 1983 and 2003, were reviewed retrospectively.

RESULTS: The median age was 58 years. Postoperatively, patients were fed nonorally and received postoperative antibiotic treatment. One patient developed mediastinitis and 3 patients a rise in body temperature. A control radiography disclosed pharyngeal leakages in 3 patients. Overall morbidity averaged 10%.

CONCLUSION: To avoid severe complications we recommend postoperative antibiotic treatment and parenteral feeding. In comparison to the stapler-assisted technique the use of the CO2 laser allows a good view at the diverticular wall throughout the procedure. The transcervical technique should be reserved for cases of anatomic abnormalities or for complicated revision surgeries.