TY - JOUR
T1 - Surgical Outcomes in Zenker Diverticula
T2 - A Multicenter, Prospective, Longitudinal Study
AU - Howell, Rebecca
AU - Johnson, Christopher
AU - Allen, Jacqui
AU - Altaye, Mekibib
AU - Amin, Milan
AU - Bayan, Semirra
AU - Belafsky, Peter
AU - Cervenka, Brian
AU - Desilva, Brad
AU - Dion, Gregory R.
AU - Ekbom, Dale
AU - Friedman, Aaron
AU - Fritz, Mark
AU - Giliberto, John Paul
AU - Guardiani, Elizabeth
AU - Kasperbauer, Jan
AU - Kim, Brandon
AU - Krekeler, Brittany N.
AU - Kuhn, Maggie
AU - Kwak, Paul
AU - Ma, Yue
AU - Madden, Lyndsay L.
AU - Matrka, Laura
AU - Mayerhoff, Ross
AU - McKeon, Mallory
AU - Piraka, Cyrus
AU - Rosen, Clark A.
AU - Tabangin, Meredith
AU - Wahab, Shaun A.
AU - Wilson, Keith
AU - Wright, Carter
AU - Young, Vy Vy N.
AU - Postma, Gregory
N1 - Publisher Copyright:
© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2024/1
Y1 - 2024/1
N2 - Objective: To compare improvement in patient-reported outcomes (PROM) in persons undergoing endoscopic and open surgical management of Zenker diverticula (ZD). Methodology: Prospective, 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. Results: One 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. Conclusion: Both 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 Evidence: 3 Laryngoscope, 134:97–102, 2024.
AB - Objective: To compare improvement in patient-reported outcomes (PROM) in persons undergoing endoscopic and open surgical management of Zenker diverticula (ZD). Methodology: Prospective, 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. Results: One 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. Conclusion: Both 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 Evidence: 3 Laryngoscope, 134:97–102, 2024.
KW - CPMD
KW - Zenker
KW - cricopharyngeal bar
KW - cricopharyngeal dysfunction
KW - cricopharyngeus muscle dysfunction
KW - hypopharyngeal diverticulum
KW - pharyngoesophageal dysphagia
UR - http://www.scopus.com/inward/record.url?scp=85159575028&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85159575028&partnerID=8YFLogxK
U2 - 10.1002/lary.30753
DO - 10.1002/lary.30753
M3 - Article
C2 - 37191092
AN - SCOPUS:85159575028
SN - 0023-852X
VL - 134
SP - 97
EP - 102
JO - Laryngoscope
JF - Laryngoscope
IS - 1
ER -