Surgical treatment for pharyngo-esophageal diverticulum: Consecutive series over 20 years

Main treatment options for pharyngoesophageal diverticulum are the surgical excision or diverticulopexy, always associated with a myotomy, and the endoscopic peroral myotomy. The aim of this study was to describe the outcomes of a consecutive surgical series.

Observational study of patients who underwent open surgery (2004-2024) and who had a 2-years structured follow-up. Main outcome were symptom resolution and postoperative complications. Baseline characteristics, surgical technique, reinterventions, readmission and recurrence were also analyzed. Descriptive statistics was used, including percentages, mean and standard deviations, and medians with complete ranges.

During the study period, 40 patients (73% male) were operated on, with a mean age of 72 ± 11 years. Ninety-five percent presented dysphagia and/or regurgitation, while 2 patients were referred due to a history of pneumonia to bronchoaspiration. The most frequent surgical technique was cricopharyngeal myotomy combined with diverticulectomy. Postoperative morbidity was 15%, with no cases of esophageal fistula. There was no mortality, and the median hospital stay was 3 days. Initial symptom resolution was achieved in 95% of patients. During follow-up (median 7 years [1-20]), 2 recurrences were observed at 18 and 24 months, respectively, both successfully managed endoscopically.

Surgical treatment achieves symptoms resolution in the vast majority of cases, with limited morbidity and recurrence.