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

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Authors

Contributions

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

Corresponding author

Correspondence to Marius Distler.

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Nitschke, P., Kemper, M., König, P. et al. Interdisciplinary Comparison of Endoscopic Laser-Assisted Diverticulotomy vs. Transcervical Myotomy as a Treatment for Zenker’s Diverticulum. J Gastrointest Surg 24, 1955–1961 (2020). https://doi.org/10.1007/s11605-019-04381-z

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Keywords

  • Zenkers diverticulum
  • Endoscopic diverticulotomy
  • Transcervical myotomy