Complications Following Surgical Management of Zenker Diverticulum: A Comparative Analysis of Endoscopic and Open Approaches.
Publication/Presentation Date
4-1-2025
Abstract
OBJECTIVE: We aim to explore the differences in complication rates in endoscopic versus open transcervical treatment of Zenker diverticulum.
STUDY DESIGN: Retrospective Cohort Study from January 1, 2015 to December 31, 2023.
SETTING: Queries of the TriNetX database's United States Collaborative Network.
METHODS: A retrospective cohort study was conducted using patients ≥18 years old diagnosed with Zenker diverticulum selected from the TriNetX United States Collaborative Network. Patients undergoing open and endoscopic diverticulectomy between 2015 and 2023 were identified and divided into cohorts and propensity score matched by age, sex, race, ethnicity, and common comorbidities.
RESULTS: Patients that underwent transcervical approach (n = 1033), when compared to patients that underwent endoscopic approach (n = 2182), had higher rates of dysphonia (odds ratio [OR]: 2.44; 95% confidence interval [CI]: 1.47-4.05; P = .001), long-term enteral feeding access (OR: 3.08; 1.74-5.46; P > .001), and infection (OR: 6.65; 3.50-12.65; P > .001). No significant difference was found in rates of esophageal perforation (OR: 1.60; 0.93-2.75; P = .087) or persistent postoperative dysphagia (OR: 1.03; 0.86-1.23, P = .75). There was no significant difference in the number of patients receiving repeat diverticulectomy procedures (OR: 0.83; 0.58-1.19; P = .314).
CONCLUSION: Based on analysis of a large healthcare database, endoscopic Zenker diverticulectomy is associated with rates of postoperative dysphonia, enteral feeding, and soft tissue infection. Both the open and endoscopic approaches offer relative advantages not captured by this population-level analysis. Thus, judicious selection of patients based on comorbidities and anatomical factors is essential for optimizing outcomes.
Volume
172
Issue
4
First Page
1328
Last Page
1333
ISSN
1097-6817
Published In/Presented At
DeKloe, J., Shing, S. R., Herzig, L., Bertoni, D., & Tibbetts, K. M. (2025). Complications Following Surgical Management of Zenker Diverticulum: A Comparative Analysis of Endoscopic and Open Approaches. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 172(4), 1328–1333. https://doi.org/10.1002/ohn.1119
Disciplines
Education | Medical Education
PubMedID
39764670
Department(s)
Department of Education
Document Type
Article