咽頭食道憩室（Ｚｅｎｋｅｒ憩室）の手術症例における臨床的特徴ならびに治療法についての検討

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  • Clinical Findings and Treatments of Patients with Zenker's Diverticulum

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Pharyngoesophageal diverticulum (Zenker's diverticulum), which is a pulsion diverticulum that occurs at a weak site in the posterior wall of the pharyngoesophagus, between the inferior constrictor of pharynx and the cricopharyngeus muscle, i. e. Killian's triangle, is rare in Japan. We treated 7 patients with Zenker's di-verticulum surgically from 1988 to 2003. We reviewed clinical findings and treatments of them. All had dysphagia initially. All underwent diverticulectomy, and 4 additionally underwent cricopharyngeal myotomy (CM). Postoperatively, 6 patients experienced dramatic alleviation of symptoms. Postoperative complications occurred in 2, i. e. pneumonia in 1 and recurrent laryngeal nerve paralysis in the other. No postoperative recur-rence was seen. We suggest that diverticulectomy added to CM is effective for Zenker's diverticulum. The patients with a large diverticulum are at risk of postoperative surgical complications due to the difficulty of the surgery, so careful operation is needed for them.

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