Open Zenker's Diverticulectomy Using Stapling Techniques

This is a prospective review of patients who underwent Zenker's diverticulectomy, closure of the pharyngotomy with nonabsorbable staples, and cricopharyngeal myotomy through an open neck approach over a period of 2 years. The study group consisted of 9 men with a mean age of 67 years. The diagnosis of Zenker's diverticulum was based on a barium swallow esophagram. The mean operative time was 1.5 hours, with a mean estimated blood loss of 25 mL. Barium swallow esophagrams performed on the first postoperative day showed no pharyngeal fistulas. Oral feeding was started after the esophagram. One patient was discharged on postoperative day I, I was discharged on postoperative day 3, and the remaining 7 were discharged on postoperative day 2. All patients were able to take oral feeding by postoperative day I. There were no operative complications in this series. We conclude that stapling with nonabsorbable staples is a relatively safe and effective method for closing pharyngeal defects after Zenker's diverticulectomy. The technique leads to shortening of the operative time and hospital stay, and allows early resumption of oral feeding.