Surgical treatment of Zenker's diverticulum.

One-hundred-and-fifty patients with Zenker's diverticulum were reviewed; twelve patients received no treatment; 26 patients were treated endoscopically by dilatation, five of these had a diverticulectomy performed at a later stage. One-hundred-and-ten patients had a diverticulectomy performed (a total of 115 primary operations were performed). Eighteen of the patients operated upon had a recurrence and six underwent re-operation. Local complications occurred in 24 patients. Seven patients had a fistula and two had mediastinitis. Ten patients had recurrent nerve palsy, of which five were permanent. Thirteen patients had other complications, usually infection. One death occurred. Post-operative prophylactic treatment with antibiotics was found to significantly reduce the number of local infectious complications and a correlation was found between the occurrence of local, infectious complications and later recurrence of the pouch.