Open AccessCarbon Dioxide Laser Versus Stapler‐Assisted Endoscopic Zenker's Diverticulotomy: A Systematic Review and Meta‐Analysis
Author(s) -
Parker Noah P.,
Misono Stephanie
Publication year - 2014
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599814521554
Subject(s) - medicine , meta analysis , dysphagia , odds ratio , confidence interval , surgery , retrospective cohort study
To evaluate outcomes following endoscopic management of Zenker's diverticula using a carbon dioxide laser (CO 2 ) or stapler‐assisted technique, a systematic review and meta‐analysis were conducted. Seven retrospective, uncontrolled case series including 391 procedures met selection criteria. No higher quality studies were identified. Outcomes favoring the stapler technique included a shorter duration of nil per os (NPO) status (2 studies), length of hospitalization (LOH, 2 studies), and fewer postoperative fevers and abnormal chest x‐rays (1 study). Outcomes favoring the CO 2 technique included greater improvement in postoperative dysphagia and regurgitation scores (2 studies) and a lower revision rate (1 study). Meta‐analysis demonstrated increased nondental complications in the CO 2 group (odds ratio 3.81; 95% confidence interval, 1.37‐10.59; P =. 01) but no difference in duration of NPO ( P =. 06), LOH ( P =. 07), overall complications ( P =. 08), dental complications ( P =. 57), major complications ( P =. 38), or revision surgery ( P =. 82). Implications are limited by the quality of studies identified.