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Introduction: Diverticulectomy and cricopharyngeal myotomy by an external approach has been the treatment of choice for Zenker's diverticulum. The need for a minimally invasive intervention has arisen because of the considerable comorbidities associated with open surgery in the advanced age group to which most patients belong. Endoscopic laser evaporation combines low risk with short hospital stay and good overall results on swallowing. We performed this study to evaluate the complications of and patient satisfaction after endoscopic laser evaporation. Materials and methods: We reviewed patient records and sent a questionnaire to all living patients registered with the diagnosis of Zenker's diverticulum treated between 1 June 1993 and 31 January 2002 at Rigshospitalet, Department of Otolaryngology, Head and Neck Surgery, Copenhagen, Denmark. Thirty-nine patients were found; of these, 37 returned the questionnaire. The patients were also asked to self-evaluate the effects of the surgery on a number of symptoms, using a visual analog scale. Results: In general, the patients reported that overall the surgery had had positive effects. All were initially without symptoms, but after one year there was a considerable number of patients with recurring symptoms. Twenty-four patients reported having to restrict their diet; only six were completely without symptoms at follow-up. We found that 14% of the patients had had complications, but these had all been mild and temporary. Discussion: The endoscopic treatment is safe, and those treated with it report satisfactory results. The open approach should be reserved for patients in whom endoscopic treatment cannot be performed. Surgery initially had an effect on the symptoms of all patients, but we found that the symptoms returned up to at least one year after surgery, and we therefore recommend a postoperative follow-up after twelve months to evaluate the need for reoperation.

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