Interdisciplinary Comparison of Endoscopic Laser-Assisted Diverticulotomy vs. Transcervical Myotomy as a Treatment for Zenker’s Diverticulum

  • Philipp Nitschke
  • Max Kemper
  • Patricia König
  • Thomas Zahnert
  • Jürgen Weitz
  • Christoph Reissfelder
  • Marius DistlerEmail author
Original Article



Currently, there are different competing techniques for the treatment of Zenker’s diverticulum (ZD). To improve patient selection, we compared endoscopic laser-assisted diverticulotomy (ELAD) with transcervical myotomy (TCM) with regard to possible risk factors for treatment failure.


Data of ZD patients (n = 104) treated between 2004 and 2016 with either TCM (38%) or ELAD (62%) were analyzed retrospectively. Univariate and multivariate analyses were performed.


TCM is associated with a higher morbidity (27.8% vs. 10.2%; p = 0.095) but lower recurrence rate (7.3% vs. 19.3%; p = 0.095). Preoperative reflux disease (OR 8.755; p = 0.021) was identified as an independent risk factor for complications.


Although short-term outcome and symptom relief are similar, TCM tends to have a higher complication rate but better long-term results. Preoperative reflux disease is an independent risk factor for postoperative complications.


Zenkers diverticulum Endoscopic diverticulotomy Transcervical myotomy 


Author Contibutions

Philipp Nitschke: study design, data analysis, data interpretation, drafting of the manuscript.

Max Kemper: data acquisition, data interpretation, manuscript revision.

Patricia König: data acquisition, data analysis, manuscript revision.

Thomas Zahnert: data interpretation, manuscript revision.

Jürgen Weitz: data interpretation, manuscript revision.

Christoph Reissfelder: data interpretation, manuscript revision.

Marius Distler: study design, data acquisition, data interpretation, manuscript revision

Supplementary material

11605_2019_4381_MOESM1_ESM.pdf (141 kb)
ESM 1 (PDF 140 kb)


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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  1. 1.Department of Visceral, Thoracic and Vascular SurgeryUniversity Hospital Carl Gustav Carus, TU DresdenDresdenGermany
  2. 2.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Carl Gustav Carus, TU DresdenDresdenGermany
  3. 3.Department of Surgery, Medical Faculty HeidelbergUniversity Hospital MannheimMannheimGermany

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