Premium
Patient reported outcomes in endoscopic and open transcervical treatment for Zenker's diverticulum
Author(s) -
Seth Rahul,
Rajasekaran Karthik,
Lee Walter T.,
Lorenz Robert R.,
Wood Benjamin G.,
Kominsky Alan,
Scharpf Joseph
Publication year - 2014
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24152
Subject(s) - medicine , zenker's diverticulum , dysphagia , surgery , choking , diverticulum (mollusc) , retrospective cohort study , anatomy
Objectives/Hypothesis To compare long‐term symptomatic outcomes between external transcervical (ET) and endoscopic stapling diverticulotomy (ESD) surgeries for Zenker's diverticulum. Study Design Retrospective review. Methods Patients undergoing surgery for Zenker's diverticulum surgery between 1998 and 2010 with at least 1 year follow‐up were telephoned and questioned for dysphagia, choking, regurgitation, and halitosis based on a validated Gastrointestinal Quality‐of‐Life Index. Symptom degree preoperatively and at phone call was assessed. Patients rated their overall postoperative symptoms as worsened, unchanged, improved, or completely resolved. Results A total of 96 patients were eligible for inclusion and 55 were successfully contacted. Of these, 24 underwent ESD and 31 had ET operations. Average follow‐up time was significantly longer for the ET group than the ESD group (5.7 vs. 3.1 years respectively, P < 0.01). Gender, age at operation, diverticulum size, and preoperative symptom scores were not statistically different between the two groups. For both techniques, symptom scores showed significant improvement postoperatively ( P < 0.01). A greater proportion of patients undergoing ET procedures reported their symptoms to be completely resolved or improved compared with the ESD group (93% vs. 67%, P = 0.015). Patients undergoing ET demonstrated a greater change or improvement in survey score compared to ESD patients (7.23 vs. 3.42, P = 0.014). Conclusion Both the ET and ESD surgeries significantly benefit patients, regardless of diverticulum size. Long‐term symptomatic outcomes between the two populations indicate that patients with ET procedures attain a greater degree of resolution of preoperative symptoms. Level of Evidence 4. Laryngoscope , 124:119–125, 2014