Outcomes of Esophageal Diverticulum Repair by Otolaryngologists and General Surgeons Over Time: A NSQIP Analysis

To assess comorbidities, complication rates, and other metrics for open esophageal diverticula repair performed by either otolaryngologists or general surgeons over time.

Retrospective database study.

National Surgery Quality Improvement Database (NSQIP).

The NSQIP database was queried for cases logged by either otolaryngologists (ENT) or general surgeons (GS) from 2005 to 2020 with CPT code 43130. Preoperative characteristics, postoperative outcomes (length of stay, complications, discharge destination), and operative time were compared between specialties and over time using SPSS and R, with significance set at 0.05.

Preoperatively, GS patients were more likely to have histories of dyspnea (P = .004), pneumonia (P < .001), and >10% body weight loss within 6 months of surgery (P = .008). While there was no significant difference in rates of postoperative complications, patients undergoing repair by ENT had shorter hospital stays, were more likely to be discharged home, and their surgeries were more frequently outpatient and elective (all P < .001). Temporal analysis demonstrated a significant year-over-year decrease in length of stay across all cases (P < .001).

Our study suggests that the differences in length of hospital stay and discharge settings may be at least partially attributed to the fact that GS patients were admitted with more preoperative comorbidities. This could reflect hospital staffing, or endoscopic management of sicker patients by ENT. Closer comparison of postoperative management strategies may further elucidate the difference in outcomes.