Author: Marcel Tantau

Redo procedure following Zenker`s diverticulum treatment – a clinical study

Introduction: The prognosis of patients with Zenker`s diverticulum is dependent mainly on the type of procedure performed, either surgical or rigid/flexible endoscopy. Purpose - evaluation of the redo procedure by reviewing correlations in patients with iterative procedures. Material and Methods: We included in the study 36 patients with cervicomediastinal Zenker diverticula treated from 2010 to 2017 at two university hospitals: Clinic of General and Esophageal Surgery. Mary Clinical Hospital Bucharest and Department of Diagnostic and Interventional Digestive Endoscopy of the Regional Institute of Hepatology and Gastroenterology Prof. Dr. Octavian Fodor, Cluj-Napoca. For the patients included in the study we studied correlations of patients with symptoms persistence and to those with reintervention with epidemiological, clinical and the treatment criteria. Results: Postprocedural symptoms we observed in 5 patients of the 29 treated endoscopically and 6 of the seven treated surgically. Statistical correlations were noted in patients with persistent symptoms after surgical treatment (p <0.01) with patients with diverticulectomy (54.5%) (p <0.01), grade III diverticula (36.4%) (p <0.01) statistical association was noticed in patients who have required reoperation and those with persistent symptoms (63.6%) (p <0.01) and with remaining dysphagia (100%) (p <0.01) and those with grade 2 dysphagia persistence (71.4%) (p <0.01), grade 3 diverticula (42.9%) (p <0.03) and the high number of comorbidities. (p <0.04) Conclusion: Undoubtedly, endoscopic treatment is being used more and more even for those cases that require further treatment. Reoperation has been necessary for patients with persistent dysphagia with voluminous diverticula and a high number of comorbidities.