title: Endoscopic stapling versus external transcervical approach for the treatment of Zenker diverticulum.
abstract: OBJECTIVE
  To compare endoscopic stapling versus external transcervical approaches in the treatment of Zenker diverticulum.
  
  
  METHODS
  A 10-year retrospective institutional review was performed to identify all patients treated for Zenker diverticulum.
  
  
  METHODS
  Academic tertiary care centre.
  
  
  METHODS
  Patients treated surgically for Zenker diverticulum were identified through an electronic records search. Patient charts were reviewed, and patients were interviewed at follow-up.
  
  
  METHODS
  Patient age, sex, duration of symptoms, procedural time, time to oral liquids, length of posttreatment hospital stay, and post procedure patient satisfaction were recorded and compared.
  
  
  RESULTS
  Ten patients treated endoscopically were compared with eight patients treated via an external approach. There were no significant differences in patient age, sex, and duration of symptoms. The external technique took significantly longer (110.88 +/- 59.61 minutes) than the staple technique (19.50 +/- 6.47 minutes) (p < .0001). There was no significant difference in time to full oral liquids (p = .11). The postsurgical hospital stay (4.71 +/- 1.98 days) was significantly longer for the external technique compared with the staple technique (2.30 +/- 2.83) (p = .03). Patient symptom relief was reported as completely resolved or improved in all cases, regardless of treatment type.
  
  
  CONCLUSIONS
  Endoscopic stapling of Zenker diverticulum achieves operative success and patient satisfaction comparable to those of traditional external transcervical techniques, with significantly decreased operative times and hospital stays, allowing for more efficient use of resources.
authors.affiliation: Division of Thoracic Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Brace
authors.forename: S Mark
authors.initials: SM
authors.lastname: Taylor
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Trites
authors.forename: Drew
authors.initials: D
authors.lastname: Bethune
authors.forename: Elhamy
authors.initials: E
authors.lastname: Attia
authors.forename: Robert D
authors.initials: RD
authors.lastname: Hart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000295:instrumentation; D016672:Zenker Diverticulum / Q000601:surgery*