Endoscopic laser-assisted diverticulotomy versus open surgical approach in the treatment of Zenker's diverticulum.

OBJECTIVES/HYPOTHESIS: This study aimed to evaluate the results of endoscopic laser-assisted diverticulotomy and the transcervical approach in treating Zenker's diverticulum.

STUDY DESIGN: Retrospective clinical study.

METHODS: Results of 155 cases after endoscopic laser-assisted diverticulotomy and the transcervical approach were retrospectively compared.

RESULTS: Primary treatment consisted of endoscopic laser-assisted diverticulotomy in 65.2%, and 34.8% were treated by a transcervical approach. Average follow-up time was 61.8 months. Surgical time, duration of hospitalization, and occurrence of minor complications were significantly lower after endoscopic approach. Recurrence rate showed a statistically significant difference in favor of open approach. Including the recurrences, 38.7% could be cured only by transcervical techniques. Patient perception of success was found to be similar for the compared treatment modalities.

CONCLUSIONS: Endoscopic approach proved to be the treatment of first choice. However, the fact that open techniques were necessary in nearly 40% of our cases suggests that this operative technique retains a substantial role in treatment of this disease.