Endoscopic stapling of pharyngeal pouch: a 10-year review of single versus multiple staple rows.

OBJECTIVE: To compare the outcomes obtained in patients undergoing endoscopic stapling of pharyngeal pouches with single versus multiple rows of staples.

STUDY DESIGN: A retrospective, 10-year review.

SUBJECTS AND METHODS: Review of medical records in 38 patients who underwent endoscopic pharyngeal pouch repair.

RESULTS: Patients who underwent stapling with multiple rows had a higher postoperative leak rate than patients who were stapled with a single row (36% vs 0%, P < 0.05). Patients with multiple rows also had a more prolonged length of stay and a slower return to both clear fluids and solid diet (P < 0.05). There was no difference in recurrence rate or patient satisfaction between the two groups.

CONCLUSION: The technique of endoscopic pharyngeal pouch stapling has the potential to achieve excellent results. The application of more than one row of staples may be necessary to divide the common wall. However, in our series this is associated with a significantly increased risk of esophageal or pouch perforation. Care should be taken during the placement of multiple rows of staples.