Surgical Outcomes in Zenker Diverticula: A Multicenter, Prospective, Longitudinal Study

Area of Science:

• Otolaryngology
• Gastroenterology
• Surgical Innovation

Background:

• Zenker diverticula (ZD) present a surgical challenge impacting patient quality of life.
• Patient-reported outcomes (PROMs) are crucial for evaluating treatment efficacy in ZD management.

Purpose of the Study:

• To compare patient-reported outcomes (PROMs) following endoscopic versus open surgical management of Zenker diverticula (ZD).

Main Methods:

• A prospective, multicenter cohort study involving patients from the POUCH Collaborative who underwent ZD surgery.
• Data collection included patient surveys, radiography, and the Eating Assessment Tool (EAT-10) pre- and post-procedure.
• Statistical analysis compared outcomes between endoscopic and open surgical groups using appropriate tests.

Main Results:

• Overall, significant EAT-10 improvement was reported, with 66% achieving 100% improvement.
• Endoscopic intervention (n=109) showed a median EAT-10 improvement of 93.3%, while open surgery (n=38) showed 100% (p=0.05).
• Intraoperative complication rates were 3.7% for endoscopic and 7.9% for open surgery.

Conclusions:

• Both endoscopic and open surgical approaches for ZD yield substantial improvements in patient-reported outcomes.
• Open diverticulectomy may offer a marginal benefit in symptomatic improvement compared to endoscopic methods.
• The open surgical group experienced a higher incidence of postoperative complications.