Surgical Outcomes in Zenker Diverticula: A Multicenter, Prospective, Longitudinal Study-Reference-Cited by-同舟云学术

Surgical Outcomes in Zenker Diverticula: A Multicenter, Prospective, Longitudinal Study

Published:2023-05-16 Issue:1 Volume:134 Page:97-102
ISSN:0023-852X
Container-title:The Laryngoscope
language:en
Short-container-title:The Laryngoscope

Author:

Howell Rebecca¹^ORCID,Johnson Christopher²^ORCID,Allen Jacqui³^ORCID,Altaye Mekibib⁴,Amin Milan⁵,Bayan Semirra⁶,Belafsky Peter⁷^ORCID,Cervenka Brian¹,Desilva Brad⁸^ORCID,Dion Gregory R.¹^ORCID,Ekbom Dale⁶^ORCID,Friedman Aaron¹^ORCID,Fritz Mark⁹,Giliberto John Paul¹⁰^ORCID,Guardiani Elizabeth¹¹,Kasperbauer Jan⁶^ORCID,Kim Brandon⁸,Krekeler Brittany N.¹¹²¹³^ORCID,Kuhn Maggie⁷^ORCID,Kwak Paul⁵,Ma Yue¹⁴^ORCID,Madden Lyndsay L.¹⁵,Matrka Laura⁸^ORCID,Mayerhoff Ross¹⁶^ORCID,McKeon Mallory¹,Piraka Cyrus¹⁷,Rosen Clark A.¹⁴^ORCID,Tabangin Meredith⁴^ORCID,Wahab Shaun A.¹⁸,Wilson Keith¹,Wright Carter¹⁵,Young VyVy N.¹⁴^ORCID,Postma Gregory²,

Affiliation:

1. Department of Otolaryngology‐Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio U.S.A.

2. Department of Otolaryngology‐Head and Neck Surgery Medical College of Georgia at Augusta University Augusta Georgia U.S.A.

3. Department of Surgery University of Auckland Auckland New Zealand

4. Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio U.S.A.

5. Department of Otolaryngology‐Head and Neck Surgery New York University Grossman School of Medicine New York New York U.S.A.

6. Department of Otolaryngology‐Head and Neck Surgery Mayo Clinic Rochester Minnesota U.S.A.

7. Department of Otolaryngology‐Head and Neck Surgery University of California—Davis Davis California U.S.A.

8. Department of Otolaryngology‐Head and Neck Surgery Ohio State University Columbus Ohio U.S.A.

9. Department of Otolaryngology‐Head and Neck Surgery University of Kentucky Lexington Kentucky U.S.A.

10. Department of Otolaryngology‐Head and Neck Surgery University of Washington Seattle Washington U.S.A.

11. Department of Otolaryngology‐Head and Neck Surgery University of Maryland Baltimore Maryland U.S.A.

12. Department of Neurology and Rehabilitation Medicine University of Cincinnati College of Medicine Cincinnati Ohio U.S.A.

13. Department of Communication Sciences and Disorders University of Cincinnati College of Allied Health Sciences Cincinnati Ohio U.S.A.

14. Department of Otolaryngology‐Head and Neck Surgery University of California—San Francisco San Francisco California U.S.A.

15. Department of Otolaryngology‐Head and Neck Surgery Wake Forest University Winston‐Salem North Carolina U.S.A.

16. Department of Otolaryngology‐Head and Neck Surgery Henry Ford Health System Detroit Michigan U.S.A.

17. Department of Gastroenterology/Hepatology Henry Ford Health System Detroit Michigan U.S.A.

18. Department of Radiology University of Cincinnati College of Medicine Cincinnati Ohio U.S.A.

Abstract

ObjectiveTo compare improvement in patient‐reported outcomes (PROM) in persons undergoing endoscopic and open surgical management of Zenker diverticula (ZD).MethodologyProspective, multicenter cohort study of all individuals enrolled in the Prospective OUtcomes of Cricopharyngeus Hypertonicity (POUCH) Collaborative who underwent surgery for ZD. Patient survey, radiography reports, and the 10‐item Eating Assessment Tool (EAT‐10) pre‐ and post‐procedure were abstracted from a REDCap database, which summarized means, medians, percentages, and frequencies of. Outcome based on operative intervention (endoscopic vs. open) was compared using t‐test, Wilcoxon rank sum test or chi‐square test, as appropriate.ResultsOne hundred and forty‐seven persons were prospectively followed. The mean age (SD) of the cohort was 68.7 (11.0). Overall, 66% of patients reported 100% improvement in EAT‐10; 81% of patients had greater than 75% improvement; and 88% had greater than 50% improvement. Endoscopic was used for n = 109 patients, and open surgical intervention was used for n = 38. The median [interquartile range, IQR] EAT‐10 percent improvement for endoscopic treatment was 93.3% [72, 100], and open was 100% [92.3, 100] (p = 0.05). The incidence of intraoperative complications was 3.7% for endoscopic and 7.9% for open surgical management. The median [IQR] in follow‐up was 86 and 97.5 days, respectively.ConclusionBoth endoscopic and open surgical management of ZD provide significant improvement in patient‐reported outcomes. The data suggest that open diverticulectomy may provide a modest advantage in symptomatic improvement compared to endoscopic management. The data suggest that the postoperative complication rate is higher in the open surgical group.Level of Evidence3 Laryngoscope, 134:97–102, 2024

Funder

American Laryngological, Rhinological and Otological Society

Publisher

Wiley

Subject

Otorhinolaryngology

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1002/lary.30753

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1. Postoperative Care of Zenker Diverticula: Contemporary Perspective from the Prospective OUtcomes Cricopharyngeaus Hypertonicity (POUCH) Collaborative;The Laryngoscope;2023-12-26