Endoscopic Stapling versus External Transcervical Approach for the Treatment of Zenker Diverticulum

Objective: To compare endoscopic stapling versus external transcervical approaches in the treatment of Zenker diverticulum. Design: A 10-year retrospective institutional review was performed to identify all patients treated for Zenker diverticulum. Setting: Academic tertiary care centre. Methods: Patients treated surgically for Zenker diverticulum were identified through an electronic records search. Patient charts were reviewed, and patients were interviewed at follow-up. Main Outcome Measures: Patient age, sex, duration of symptoms, procedural time, time to oral liquids, length of posttreatment hospital stay, and post procedure patient satisfaction were recorded and compared. Results: Ten patients treated endoscopically were compared with eight patients treated via an external approach. There were no significant differences in patient age, sex, and duration of symptoms. The external technique took significantly longer (110.88 +/- 59.61 minutes) than the staple technique (19.50 +/- 6.47 minutes) (p < .0001). There was no significant difference in time to full oral liquids (p = .11). The postsurgical hospital stay (4.71 +/- 1.98 days) was significantly longer for the external technique compared with the staple technique (2.30 +/- 2.83) (p = .03). Patient symptom relief was reported as completely resolved or improved in all cases, regardless of treatment type. Conclusions: Endoscopic stapling of Zenker diverticulum achieves operative success and patient satisfaction comparable to those of traditional external transcervical techniques, with significantly decreased operative times and hospital stays, allowing for more efficient use of resources.