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

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Journal of Gastrointestinal Surgery Aims and scope

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 and Affiliations

  1. Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany

    Philipp Nitschke, Patricia König, Jürgen Weitz & Marius Distler

  2. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany

    Max Kemper & Thomas Zahnert

  3. Department of Surgery, Medical Faculty Heidelberg, University Hospital Mannheim, Mannheim, Germany

    Christoph Reissfelder

Authors
  1. Philipp Nitschke
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  2. Max Kemper
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  3. Patricia König
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  4. Thomas Zahnert
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  5. Jürgen Weitz
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  6. Christoph Reissfelder
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  7. Marius Distler
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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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  • DOI: https://doi.org/10.1007/s11605-019-04381-z

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