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Endoscopic stapling versus laser for Zenker diverticulum: a retrospective cohort study
Simone Zanghì1, Stefano Siboni1, Emanuele Asti1
1Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milan, Piazza Malan 1, 20097, San Donato Milanese, Milan, Italy.
Summary
Endoscopic stapling (ES) and endoscopic laser (EL) effectively treat Zenker diverticulum. Patients undergoing endoscopic laser treatment reported significantly higher postoperative quality of life compared to those treated with endoscopic stapling.
Area of Science:
- Gastroenterology
- Surgical Endoscopy
- Digestive Diseases
Background:
- Zenker diverticulum is a condition affecting the upper esophagus.
- Endoscopic techniques have evolved for its treatment.
- Comparative studies on endoscopic stapling (ES) versus endoscopic laser (EL) are limited.
Purpose of the Study:
- To compare the safety and efficacy of endoscopic stapling (ES) versus endoscopic laser (EL) for symptomatic Zenker diverticulum.
- To evaluate postoperative outcomes, including swallowing function and quality of life.
Main Methods:
- Observational study analyzing a prospectively collected database.
- 36 patients treated with ES (n=19) or EL (n=17) were included.
- Functional Outcome Swallowing Scale (FOSS) and MD Anderson Dysphagia Inventory (MDADI) were used for assessment.
Main Results:
- Diverticula were smaller in the ES group compared to the EL group (p=0.002).
- Two perforations occurred in the EL group.
- Both ES and EL improved symptoms; EL showed a significant decrease in FOSS scores (p<0.001) and greater MDADI improvements (p<0.001).
Conclusions:
- Endoscopic stapling (ES) and endoscopic laser (EL) are effective treatments for Zenker diverticulum.
- Endoscopic laser (EL) resulted in significantly higher postoperative quality of life compared to ES.
