Surgical Techniques for Zenker’s Diverticulum: A Comparative Analysis

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Abstract

Objective

To compare the different modalities for treatment of Zenker’s diverticulum and the associated clinical outcomes.

Study Design

Case series with chart review.

Setting

Tertiary care hospital.

Subjects and Methods

Between 1995 and 2011, 164 patients underwent surgery for Zenker’s diverticulum (stapler, n = 69; laser, n = 68; open, n = 27). Patient sociodemographics, medical comorbidities, pre- and postoperative subjective dysphagia and regurgitation score, complications, length of stay, time to oral intake, and recurrence were reviewed for each surgical modality.

Results

No statistically significant difference in diverticulum prevalence was associated with age, gender, or treatment group. Mean length of hospital stay was not significantly different between the 3 groups (P = .14). A significant difference in time to oral intake was observed in the laser group compared with the other 2 groups (P = .012). No significant difference in recurrence (P = .21) or complication (P = .12) rates was identified between the 3 groups. Although all 3 groups demonstrated a significant decrease between preoperative and postoperative dysphagia and regurgitation scores, the degree of improvement was not significant when the 3 groups were compared.

Conclusion

There is no single “best” approach to Zenker’s diverticulum. The open, laser, and stapler methods are equally effective and have similar complication rates.

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