Surgical Techniques for Zenker's Diverticulum: A Comparative Analysis.
To compare the different modalities for treatment of Zenker's diverticulum and the associated clinical outcomes.



Case series with chart review.



Tertiary care hospital.



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.



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.



There is no single "best" approach to Zenker's diverticulum. The open, laser, and stapler methods are equally effective and have similar complication rates.
Department of Otolaryngology-Head and Neck Surgery, University of Miami-Miller School of Medicine, Miami, Florida, USA.
Jason M
JM
Leibowitz
Department of Otolaryngology-Head and Neck Surgery, University of Miami-Miller School of Medicine, Miami, Florida, USA.
Christopher E
CE
Fundakowski
Department of Otolaryngology-Head and Neck Surgery, University of Miami-Miller School of Medicine, Miami, Florida, USA mabouyared@med.miami.edu.
Marianne
M
Abouyared
Department of Otolaryngology-Head and Neck Surgery, University of Miami-Miller School of Medicine, Miami, Florida, USA.
Andrew
A
Rivera
Department of Otolaryngology-Head and Neck Surgery, University of Miami-Miller School of Medicine, Miami, Florida, USA.
Jason
J
Rudman
Department of Epidemiology and Public Health, University of Miami-Miller School of Medicine, Miami, Florida, USA.
Ka-Ming
KM
Lo
Department of Otolaryngology-Head and Neck Surgery, University of Miami-Miller School of Medicine, Miami, Florida, USA.
Donald
D
Weed
Department of Otolaryngology-Head and Neck Surgery, University of Miami-Miller School of Medicine, Miami, Florida, USA.
Francisco
F
Civantos
D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D004238:Diverticulitis / Q000150:complications / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000379:methods; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000601:surgery*
Zenker’s diverticulum; dysphagia; endoscopic; laser; stapler