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Endoscopic stapler versus laser diverticulotomy for Zenker's diverticulum: a systematic review and meta-analysis

Published online by Cambridge University Press:  16 November 2022

D Edwards Open the ORCID record for D Edwards [Opens in a new window] ,
E Prades ,
C Thorne  and
A Harris
D Edwards*
Affiliation:
Department of ENT Surgery, University Hospital of Wales, Cardiff, Wales, UK
E Prades
Affiliation:
Department of ENT Surgery, Glan Clwyd Hospital, Rhyl, Wales, UK
C Thorne
Affiliation:
Department of Anaesthetics, North Bristol NHS Trust, Newport, Wales, UK
A Harris
Affiliation:
Department of ENT Surgery, Aneurin Bevan University Health Board, Newport, Wales, UK
*
Author for correspondence: Mr Daniel Edwards, Department of ENT Surgery, University Hospital of Wales, Heath Park Way, Cardiff CF14 4XW, UK E-mail: daniel.edwards@wales.nhs.uk
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Abstract

Objective

A literature review and meta-analysis was performed to assess for difference in rate of complications and need for revision surgery between endoscopic stapler-assisted diverticulotomy and endoscopic carbon dioxide laser diverticulotomy. The hypothesis was that endoscopic stapler-assisted diverticulotomy has a lower complication rate but endoscopic carbon dioxide laser diverticulotomy has a lower need for revision surgery.

Method

This was a systematic review of English-language studies comparing endoscopic stapler-assisted diverticulotomy and endoscopic carbon dioxide laser diverticulotomy for the treatment of Zenker's diverticulum. Meta-analysis of results with regard to rate of pharyngeal perforation, major post-operative complication and need for re-operation was performed.

Results

Nine retrospective studies were included with pooled analysis of 417 endoscopic stapler-assisted diverticulotomy and 413 endoscopic carbon dioxide laser diverticulotomy cases. Meta-analysis found no significant difference in rate of pharyngeal perforation, major complication or need for re-operation between the two groups.

Conclusion

This study demonstrated both endoscopic stapler-assisted diverticulotomy and endoscopic carbon dioxide laser diverticulotomy to be a safe alternative to open surgery for Zenker's diverticulum. Both appear to be similar in terms of adverse events and efficacy. The authors recommend either approach, guided by surgeon's preference and experience, where patients are unsuitable for an open surgery approach.

Keywords

Deglutition DisordersPharynxSwallowingDiverticulumEndoscopy
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 7 , July 2023 , pp. 718 - 724
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr Daniel Edwards takes responsibility for the integrity of the content of the paper

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