How do the outcomes of laser endoscopic repair of Zenker diverticulum compare to the outcomes of stapling procedures?

Updated: Jan 23, 2018
  • Author: Joel A Ernster, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
  • Print
Answer

Answer

A study by Adam et al examining the efficacy of CO2 laser versus stapling technique in the endoscopic repair of Zenker diverticulum found that although both procedures were effective in treating the condition, the laser technique was more effective. The retrospective review, in which 148 patient charts were examined, found lower recurrence rates in patients treated by laser, as well as better outcomes in these patients with regard to dysphagia and regurgitation. [49]

In another study of the two techniques, Parker and Misono found that the CO2 laser and stapling procedures were similar with regard to most, but not all, types of complications in Zenker diverticulum treatment. The report, a meta-analysis of 391 procedures from seven retrospective, uncontrolled studies, found no differences in the prevalence of dental complications, major complications, overall complications, or revision surgery, as well as none in the length of time that patients were nil per os. However, nondental complications were more frequent in patients who underwent the CO2 laser procedure. [50]

In a study by Barton et al of 106 patients, endoscopic laser- and stapler-assisted diverticulotomies were both found to be effective in short- and long-term symptom management and to be associated with high levels of patient satisfaction. Reviewing historical data for the stapler-assisted procedure alone at the single institution where the study was carried out, the investigators found that the addition of the laser-assisted technique produced a decline in the endoscopic diverticulotomy failure rate, with no rise in serious complications. [51]


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!