Surgical Techniques for Zenker’s Diverticulum

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.