Evaluation of endoscopic harmonic diverticulostomy.

Published

Journal Article

OBJECTIVES/HYPOTHESIS: The purpose of this study is to review a consecutive series of patients with Zenker's diverticulum who were treated with endoscopic diverticulostomy using either the endoscopic stapler (ENDO GIA 30 Autosuture; Covidien, Dublin, Ireland) or Harmonic Ultrasonic Surgical Instrumentation (Ethicon Endo-Surgery, Cincinnati, OH) to evaluate the safety and optimal application of Harmonic technology to the treatment of patients with Zenker's diverticulum. STUDY DESIGN: This is a retrospective review at a tertiary academic hospital with institutional review board approval. METHODS: All patients undergoing endoscopic repair of Zenker's diverticulum between April 1, 2009 and December 1, 2010 at a single institution were studied. RESULTS: A total of 65 endoscopic diverticulostomies were performed: 24 Harmonic assisted, 41 stapler assisted. Average diverticulum size was 3.46 cm. There were two complications with staple-assisted (pharyngeal leak and recurrence) and six complications with Harmonic-assisted diverticulostomies (two pharyngeal leaks, two chest pains, one recurrence, and one subcutaneous emphysema). There was a statistically significant difference in the complication rates between the staple-assisted (4.88%) and Harmonic-assisted (25%) cohorts (P = .04). There were no complications with diverticula <2 cm. CONCLUSIONS: Endoscopic Harmonic esophagodiverticulostomy has been reported for the treatment of Zenker's diverticula. However, our data demonstrate a significantly higher complication rate with use of the Harmonic technology compared to the staple-assisted method (P = .04). Additional evaluations are warranted to validate these findings and before Harmonic diverticulostomy can be recommended as treatment for the majority of cases.

Full Text

Duke Authors

Cited Authors

  • Whited, C; Lee, WT; Scher, R

Published Date

  • June 2012

Published In

Volume / Issue

  • 122 / 6

Start / End Page

  • 1297 - 1300

PubMed ID

  • 22447228

Pubmed Central ID

  • 22447228

Electronic International Standard Serial Number (EISSN)

  • 1531-4995

Digital Object Identifier (DOI)

  • 10.1002/lary.23251

Language

  • eng

Conference Location

  • United States