Comparison of endoscopic diathermy and resection in the surgical treatment of pharyngeal diverticula

Pharyngeal diverticula were classified by Zenker and Ziemssen in 1877, but it was not until 1886 that Wheeler reported the first successful excision. Excision of diverticula at that time carried a high operative mortality due to sepsis, and consequently Goldman proposed a two-stage operation in 1909 to try to overcome this. The two-stage operation became the treatment of choice, but following the advent of antibiotics this was largely superseded by the one-stage procedure (Boyes-Korkis, 1958; Clagett and Payne, 1960; Bertelsen and Aastad, 1976; Butcher and Larrabee, 1979). Endoscopic diathermy as a method of treating pharyngeal diverticula was pioneered by Dohlman, who reported a series of 39 patients treated with this technique between 1939 and 1945. By 1958 his series (Dohlman and Mattson, 1958) had risen to nearly 100 patients, with a recurrence rate of only 7 per cent and no associated deaths or severe complications. To the authors' knowledge, there has been no previous study directly comparing the external and endoscopic methods of treatment of pharyngeal diverticula. This paper sets out to compare the two methods retrospectively in a series of 60 patients.