[Zenker's diverticulum in the elderly patient: evolution of endoscopic treatment using a CO2 laser]

The authors report their experience in a retrospective study of 28 patients with symptomatic hypopharyngeal diverticulum.

The mean age was 70 years. Eight patients presented with severe dysphagia and nine with weight's loss. The delay before diagnosis was 17 months. All patients included were studied by an oesophageal barium swallow prior to any treatment. According to Van Overbeeck's classification, diverticula were medium sized in 11 patients, small in 8 and large in 7. All patients had endoscopic assessment of the diverticular pouch; 26 patients were treated by microendoscopic laser myotomy and 2 by resection.

The average time for oral feeding was 4 days. None of the 28 cases had a postoperative complication. 25 patients had partial or complete relief of symptoms after their initial treatment. In 3 cases recurrence of symptoms occurred, of whom 2 underwent endoscopic revision and 1 underwent an open procedure.

Endoscopic laser surgery for Zenker's diverticulum can be recommended as the treatment of choice for elderly patients. It is a useful procedure because it is swift, effective with a low rate of morbidity, even in cases with impaired of health or associated diseases.