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The authors aimed to elucidate the indications of transcervical surgical approach and also to review the literature in the treatment of symptomatic Zenker’s diverticulum (ZD), focusing on clear indications for open surgery (diverticulectomy with cricopharyngeal myotomy). The authors analyzed the efficacy of open surgery versus the current standard endoscopic diverticulotomy, focusing on the size of the diverticulum, surgical approach, and postoperative morbidity..

Following a retrospective search in the literature using Medline and PuBMed database of the past 5 years, the authors found 79 articles about the treatment of symptomatic Zenker’s diverticulum (keywords: Zenker’s diverticulum, open surgery, endoscopic diverticulectomy). 25 papers were included, the exclusion criteria were small number of patients, non-english publications.

Although endoscopic diverticulectomy is the preferred method of treatment in symptomatic Zenker’s diverticulum, in those cases, in which the patient is not eligible for endoscopic treatment, open surgery is a safe and reliable choice when treating a small ZD.