Dysphagia after endoscopic repair of Zenker's diverticulum

Andrew D. Palmer, Heather C. Herrington, Ionel C. Rad, James Cohen

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVES/HYPOTHESIS: To determine whether patient outcomes after endoscopic staple-assisted diverticulectomy (ESD) were correlated with demographic or disease-specific patient characteristics. STUDY DESIGN: Retrospective chart review with follow-up. METHODS: A survey was sent to all eligible subjects who had undergone ESD from February 1995 to June 2004 to gather information about their postoperative weight, diet, dysphagia symptoms, distress, and overall satisfaction. RESULTS: Thirty-five individuals responded (49% response rate) at a mean of 29 (range, 3-83) months postoperative. There was a significant reduction in the following symptoms: food avoidance, regurgitation, dysphagia for pills, choking, coughing, difficulty finishing a meal, heartburn/reflux, and halitosis. There was no significant difference for dysphonia. Swallow-related distress had decreased from a preoperative level of 7.86 to 2.23 at follow-up (P <.001). Overall satisfaction with the surgery was high. There were no significant differences in outcome by any demographic characteristic, duration of preoperative symptoms, presence of gastroesophageal reflux disease, Zenker's diverticulum size, time since surgery, or number of surgeries. Ninety-one percent of subjects reported improvement in their swallowing after surgery, but 22% reported some decline since that time. Symptomatic subjects reported significantly higher swallow-related distress and lower satisfaction (P <.01). Preoperative variables were not correlated with a return of symptoms. Individuals who underwent multiple procedures had similar levels of benefit and satisfaction as those who underwent a single ESD procedure. CONCLUSION: ESD results in high levels of patient satisfaction, significant reduction in postoperative symptoms, low levels of complications, and the opportunity to safely and successfully repeat the procedure if necessary.

Original languageEnglish (US)
Pages (from-to)617-622
Number of pages6
JournalLaryngoscope
Volume117
Issue number4
DOIs
StatePublished - Apr 2007

Fingerprint

Zenker Diverticulum
Deglutition Disorders
Deglutition
Swallows
Halitosis
Demography
Dysphonia
Heartburn
Airway Obstruction
Gastroesophageal Reflux
Patient Satisfaction
Meals
Diet
Weights and Measures
Food

Keywords

  • Cricopharyngeal myotomy
  • Dysphagia
  • Endoscopic diverticulostomy
  • Zenker's diverticulum

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Dysphagia after endoscopic repair of Zenker's diverticulum. / Palmer, Andrew D.; Herrington, Heather C.; Rad, Ionel C.; Cohen, James.

In: Laryngoscope, Vol. 117, No. 4, 04.2007, p. 617-622.

Research output: Contribution to journalArticle

Palmer, Andrew D. ; Herrington, Heather C. ; Rad, Ionel C. ; Cohen, James. / Dysphagia after endoscopic repair of Zenker's diverticulum. In: Laryngoscope. 2007 ; Vol. 117, No. 4. pp. 617-622.
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abstract = "OBJECTIVES/HYPOTHESIS: To determine whether patient outcomes after endoscopic staple-assisted diverticulectomy (ESD) were correlated with demographic or disease-specific patient characteristics. STUDY DESIGN: Retrospective chart review with follow-up. METHODS: A survey was sent to all eligible subjects who had undergone ESD from February 1995 to June 2004 to gather information about their postoperative weight, diet, dysphagia symptoms, distress, and overall satisfaction. RESULTS: Thirty-five individuals responded (49{\%} response rate) at a mean of 29 (range, 3-83) months postoperative. There was a significant reduction in the following symptoms: food avoidance, regurgitation, dysphagia for pills, choking, coughing, difficulty finishing a meal, heartburn/reflux, and halitosis. There was no significant difference for dysphonia. Swallow-related distress had decreased from a preoperative level of 7.86 to 2.23 at follow-up (P <.001). Overall satisfaction with the surgery was high. There were no significant differences in outcome by any demographic characteristic, duration of preoperative symptoms, presence of gastroesophageal reflux disease, Zenker's diverticulum size, time since surgery, or number of surgeries. Ninety-one percent of subjects reported improvement in their swallowing after surgery, but 22{\%} reported some decline since that time. Symptomatic subjects reported significantly higher swallow-related distress and lower satisfaction (P <.01). Preoperative variables were not correlated with a return of symptoms. Individuals who underwent multiple procedures had similar levels of benefit and satisfaction as those who underwent a single ESD procedure. CONCLUSION: ESD results in high levels of patient satisfaction, significant reduction in postoperative symptoms, low levels of complications, and the opportunity to safely and successfully repeat the procedure if necessary.",
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