The safety and efficacy of endoscopic Zenker's diverticulotomy

A cohort study

Michelle Dechant Barton, Kara Y. Detwiller, Andrew D. Palmer, Joshua Schindler

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives/Hypothesis: To determine whether the application of laser-assisted techniques for the treatment of Zenker's diverticulum would reduce the failure rate of endoscopic procedures without compromising safety or durability. Study Design: Cohort study with long-term follow-up. Methods: We performed a single-institution review of 106 consecutive patients in whom endoscopic laser-assisted diverticulotomy (ELD) or endoscopic stapler-assisted diverticulotomy (ESD) was attempted. The Eating Assessment Tool was collected pre- and postoperatively. Long-term follow-up was conducted on average 2.4 years postoperatively. Results: The decision to use either ELD or ESD was made intraoperatively. An endoscopic procedure was successfully completed in 103 of 106 patients (97.2%). Eighty-three patients underwent ELD, 20 underwent ESD, and only three required use of an open approach. No serious complications occurred. Postoperatively, there was a significant reduction in dysphagia symptoms. At follow-up, most individuals had dysphagia scores within the normal range (69%) and were eating a regular diet (73%). Fourteen patients (14%) required revision. Compared to historical data from our institution for ESD alone, the addition of ELD resulted in a reduction in the failure rate without an increase in serious complications. Recurrence rates and long-term outcomes were equivalent. Conclusion: Through careful patient selection, appropriate workup, and judicious use of techniques, it was possible to perform endoscopic surgery in a majority of patients without serious complications. Both approaches resulted in short- and long-term symptom management with high levels of satisfaction.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - 2016

Fingerprint

Lasers
Cohort Studies
Safety
Deglutition Disorders
Eating
Zenker Diverticulum
Patient Selection
Reference Values
Diet
Recurrence
Therapeutics

Keywords

  • Carbon dioxide laser
  • Dysphagia
  • Endoscopy
  • Patient satisfaction
  • Surgical stapler
  • Zenker's diverticulum

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

The safety and efficacy of endoscopic Zenker's diverticulotomy : A cohort study. / Barton, Michelle Dechant; Detwiller, Kara Y.; Palmer, Andrew D.; Schindler, Joshua.

In: Laryngoscope, 2016.

Research output: Contribution to journalArticle

Barton, Michelle Dechant ; Detwiller, Kara Y. ; Palmer, Andrew D. ; Schindler, Joshua. / The safety and efficacy of endoscopic Zenker's diverticulotomy : A cohort study. In: Laryngoscope. 2016.
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