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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 3 - Laryngology/Broncho-Esophagology

Complications Following Surgical Management of Zenker Diverticulum: A Comparative Analysis of Endoscopic and Open Approaches

Monday, September 30, 2024
10:00 AM – 10:06 AM EDT
Location: MBCC, 224
Disclosure(s):
Samuel R. Shing, BS, BA:

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

Dylan G. Bertoni, MD:

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

Kathleen M. Tibbetts, MD:

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

Introduction: Zenker diverticulum is a rare condition affecting less than 1% of the population. Surgical management options include open transcervical and endoscopic diverticulectomy. This study utilizes a large database to compare the rates of complications between the two techniques.

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 2000-2023 were identified and divided into cohorts. Outcomes compared included perforation, post-operative infection, need for long-term enteral feeding access, nerve injury, and mortality. Outcomes occurring within one month of the procedure were included in the analysis.

Results: Queries identified 1,172 patients that underwent open diverticulectomy and 1,930 patients that underwent endoscopic diverticulectomy. The overall mortality rate at one month was 0.65% with no significant difference between the two approaches (OR = 1.07, CI = 0.44-2.63, p = 0.88). Rates of esophageal perforation were similar between the two groups (OR = 4.52; CI = 0.76-2.12; p = 0.36). Odds of post-operative infection, nerve injury, and need for long-term enteral feeding access were significantly higher in the open approach cohort compared to the endoscopic approach (OR = 2.48, 1.97, 4.52; p = 0.014, 0.0014, 0.00025).

Conclusions: Based on analysis of a large healthcare database, endoscopic Zenker diverticulectomy offers a more favorable risk profile than the open approach which carries an increased risk of postoperative infection, nerve injury, and need for long-term enteral feeding access.

    Presenting Author(s)

  • Jefferson J. DeKloe, BS

    Medical Student
    Thomas Jefferson University Department of Otolaryngology
    Philadelphia, Pennsylvania, United States

    Disclosure information not submitted.

    • Co-Author(s)

  • Samuel R. Shing, BS, BA

    Research Fellow
    Thomas Jefferson University Department of Otolaryngology
    Philadelphia, Pennsylvania, United States

    Disclosure(s):

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

  • DB

    Dylan G. Bertoni, MD

    Resident
    Thomas Jefferson University Department of Otolaryngology
    Philadelphia, PA, United States

    Disclosure(s):

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

    • Senior Author(s)

  • KT

    Kathleen M. Tibbetts, MD

    Associate Professor
    Thomas Jefferson University Department of Otolaryngology-Head and Neck Surgery
    Philadelphia, PA, United States

    Disclosure(s):

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