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Endoluminal treatment for Zenker's diverticulum - a population-based observational study
Eirik Østensen Søfteland1, Anne Kristin Aasebøstøl2, Gjermund Johnsen1,3
1Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Scandinavian Journal of Gastroenterology
|September 20, 2023
Summary
Zenker's diverticulum treatments, including endoscopic stapled and laser diverticulostomy, are safe but have significant recurrence risks. Further research is needed to improve long-term outcomes for patients with this esophageal condition.
Area of Science:
- Gastroenterology
- Otolaryngology
- Surgical Innovation
Background:
- Zenker's diverticulum is a pharyngeal outpouching causing dysphagia and regurgitation.
- Treatment in Central Norway is centralized, utilizing either endoscopic stapled or laser diverticulostomy.
- Diverticula size dictates the surgical approach at St. Olavs hospital.
Purpose of the Study:
- To compare the safety and efficacy of endoscopic stapled versus laser diverticulostomy for Zenker's diverticulum.
- To analyze pre-, intra-, and postoperative variables between the two treatment modalities.
- To assess the long-term recurrence rates for each endoscopic approach.
Main Methods:
- Retrospective, population-based study of patients treated between 2001-2020.
- Inclusion of patients who underwent rigid endoscopic diverticulostomy.
- Comparison of treatment groups using in-hospital records for demographic and clinical data.
Main Results:
- 78 patients underwent 104 interventions; crude incidence was 0.57/100,000/year.
- Laser group had more postoperative infections (19.6% vs 3.4%) despite less antibiotic prophylaxis.
- Clinical recurrence rates were 35% for stapler and 51% for laser at median 119 months follow-up.
Conclusions:
- Both endoscopic stapled and laser diverticulostomy are safe for Zenker's diverticulum.
- A substantial risk of clinical recurrence exists for both procedures.
- Treatment choice may influence postoperative infection rates and long-term outcomes.
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