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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 1 - Laryngology/Broncho-Esophagology

Hiatal Hernia and Zenker’s Diverticulotomy Outcomes

Saturday, September 28, 2024
9:42 AM – 9:48 AM EDT
Location: MBCC, 224
Disclosure(s):
Lazaro R. Peraza, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Katherine P. Wallerius, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Hawa M. Ali, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Andrew S. Awadallah, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Our objective is to compare reflux symptoms, Zenker’s diverticulum recurrence, and clinical outcomes in patients with and without history of hiatal hernia who underwent Zenker’s diverticulotomy.

Methods: A retrospective review of patients with and without history of hiatal hernia who underwent Zenker’s diverticulotomy (ZD) via an open stapler, rigid endoscopic CO2 laser, stapler or harmonic scalpel technique from January 2006 to December 2020 was performed. Data were abstracted for patient demographics, reflux symptoms, and rates of adverse events and symptomatic recurrence.

Results: Out of 325 patients, 77 (21.9%) had a history of hiatal hernia. Nine patients with history of hiatal hernia had undergone Nissen fundoplication prior to Zenker’s diverticulotomy. No significant differences were noted between patients with and without history of hiatal hernia in age, sex, race, body mass index, and Charlson Comorbidity Index. Significant differences were noted in the change in Eating Assessment Tool (EAT-10) (p < 0.01) and Reflux Symptom Index (RSI) (p = 0.03). In EAT-10 score, non-hiatal hernia patients appear to have improved more than hiatal hernia patients, with a mean score going from 18 to 2.4 and 14.9 to 3.6, respectively, while in RSI, non-hiatal hernia patients appear to have improved more than hiatal hernia patients, with a mean score going from 22.9 to 5.1 and 22 to 6.5, respectively. No significant differences were found between groups for likelihood of a postoperative adverse event (infection, bleeding, perforation, emergency department visit, readmission) or Zenker’s diverticulum recurrence.

Conclusions: Patients without history of hiatal hernia had significantly larger improvements in EAT-10 and RSI scores compared to patients with history of hiatal hernia. There were no significant differences in postoperative adverse events or in recurrence of the Zenker’s diverticulum between groups.

    Presenting Author(s)

  • LP

    Lazaro R. Peraza, MD

    Resident
    Mayo Clinic
    Rochester, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Katherine P. Wallerius, MD

    Resident
    Mayo School of Graduate Medical Education (Rochester)
    Rochester, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Hawa M. Ali, MD

    Resident
    Mayo Clinic Department of Otolaryngology-Head and Neck Surgery
    Rochester, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • JO

    Jamie J. O'Byrne, MS

    Biostatistician
    Mayo Clinic Department of Quantitative Health Sciences
    Rochester, MN, United States

    Disclosure information not submitted.

  • Aisha A. Aden, BS

    Medical Student
    Mayo Clinic Alix School of Medicine
    Rochester , MN, United States

    Disclosure information not submitted.

  • AB

    Andrew Bowen, MD

    Resident
    Mayo School of Graduate Medical Education (Rochester), United States

    Disclosure information not submitted.

  • KX

    Katherine Xie, MD

    University of Minnesota, United States

    Disclosure information not submitted.

  • Andrew S. Awadallah, BS

    Medical Student
    Mayo Clinic Alix School of Medicine
    Rochester, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • SB

    Semirra L. Bayan, MD

    Assistant Professor of Otolaryngology
    Mayo Clinic, USA

    Disclosure information not submitted.

    • Senior Author(s)

  • Dale C. Ekbom, MD

    Associate Professor of Otolaryngology, Director of Voice Disorders/Laryngology
    Mayo Clinic
    Rochester, MN, United States

    Disclosure information not submitted.