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Title: Pharyngo-oesophageal diverticulum (Zenker's). Clinical, therapeutic and morphological aspects
Authors: Lerut, Antoon ×
Van Raemdonck, Dirk
Guelinckx, Julien
Van Clooster, P
Gruwez, J A
Dom, René
Geboes, Karel
Mebis, Joseph
Janssens, J
Vantrappen, Gaston #
Issue Date: 1990
Publisher: Acta Medica Belgica
Series Title: Acta Gastro-Enterologica Belgica vol:53 issue:3 pages:330-7
Abstract: In a series of 100 surgically treated patients, Zenker's diverticulum (ZD) appeared mostly as a typical geriatric disorder (50 % over 70 years) in which not only oesophageal symptoms but also pulmonary symptoms (37 %) may lead to a life-threatening situation. In 60 % of the patients, associated upper gastrointestinal pathology was observed, most frequently being gastro-oesophageal reflux (30 patients). In 30 % of the manometric studies of the oesophageal body and lower oesophageal sphincter, clear pathological patterns were observed. Morphological examinations, enzymohistochemistry, immunohistochemistry showed clear pathological changes not only at the level of the cricopharyngeal muscle but also at the level of the striated muscles of the cervical oesophagus. These clinical, manometric and morphological changes suggest that ZD is one expression of a more complex neurogenic disorder. They also justify the extramucosal myotomy of the cricopharyngeal wall and the striated muscle wall of the cervical oesophagus as well, as the cardinal step of operation. This myotomy was combined with a diverticulopexy resulting in no postoperative mortality and a minimum of morbidity. The mean longterm follow-up in this series is 4 years, showing excellent and very good results in 96 % of the patients for the oesophageal symptoms and in 92 % for the full spectrum of oesophageal and pulmonary symptomatology. With this single step operation, no recurrence has been seen seen as opposed to the endoscopic procedure.
ISSN: 0001-5644
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Thoracic Surgery
Faculty of Medicine - miscellaneous
Translational Research in GastroIntestinal Disorders
Translational Cell & Tissue Research
Plastic, Reconstructive and Estetic Surgery Section (-)
× corresponding author
# (joint) last author

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