[Long-term outcomes after endoscopic treatment of patients with Zenker's diverticulum]

To assess the long-term outcomes after endoscopic treatment of patients with Zenker's diverticulum.

A single-center retrospective study included 207 patients with Zenker's diverticulum who underwent surgery between July 2014 and November 2021. There were 213 interventions including surgeries for recurrence. All patients were followed throughout long-term period with assessment of clinical symptoms before and after surgery.

Long-term treatment outcomes (>1 year) were assessed in 168 patients who underwent 174 interventions (27 - standard technique, 35 - tunnel technique, 112 - combined technique). Mean follow-up period was 38 months. All clinical symptoms significantly decreased after combined interventions, while the most common symptoms decreased after standard and tunnel procedures. Mean preoperative score of symptoms in all groups ranged from 10.0 to 11.0. After surgery, this indicator significantly decreased in all groups (5.0 (0.5-9.5) after standard procedure, 1.0 (0.0-3.0) after tunnel technique, 0.0 (0.0-2.0) after combined intervention). Recurrence developed in 48.2% of cases after standard surgery, 8.6% after tunnel method and 0.9% after combined procedure.

Standard endoscopic treatment of Zenker's diverticulum is associated with large number of recurrences requiring redo interventions. New methods of endoscopic treatment combining complete transection of cricopharyngeal muscle with upper esophageal myotomy (tunnel and combined techniques) provide significant or complete reduction of clinical symptoms in long-term postoperative period with low recurrence rate.