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Keywords:

  • Zenker's diverticulum;
  • surgery;
  • laser;
  • diverticulotomy;
  • recurrence;
  • Level of Evidence: 2b

Abstract

Objectives/Hypothesis:

This study aimed to evaluate the results of endoscopic laser-assisted diverticulotomy and the transcervical approach in treating Zenker's diverticulum.

Study Design:

Retrospective clinical study.

Methods:

Results of 155 cases after endoscopic laser-assisted diverticulotomy and the transcervical approach were retrospectively compared.

Results:

Primary treatment consisted of endoscopic laser-assisted diverticulotomy in 65.2%, and 34.8% were treated by a transcervical approach. Average follow-up time was 61.8 months. Surgical time, duration of hospitalization, and occurrence of minor complications were significantly lower after endoscopic approach. Recurrence rate showed a statistically significant difference in favor of open approach. Including the recurrences, 38.7% could be cured only by transcervical techniques. Patient perception of success was found to be similar for the compared treatment modalities.

Conclusions:

Endoscopic approach proved to be the treatment of first choice. However, the fact that open techniques were necessary in nearly 40% of our cases suggests that this operative technique retains a substantial role in treatment of this disease.