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Evaluation of endoscopic harmonic diverticulostomy.

Publication ,  Journal Article
Whited, C; Lee, WT; Scher, R
Published in: Laryngoscope
June 2012

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.

Duke Scholars

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Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

June 2012

Volume

122

Issue

6

Start / End Page

1297 / 1300

Location

United States

Related Subject Headings

  • Zenker Diverticulum
  • Ultrasonic Therapy
  • Treatment Outcome
  • Tensile Strength
  • Surgical Stapling
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Postoperative Complications
  • Otorhinolaryngology
 

Citation

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Whited, C., Lee, W. T., & Scher, R. (2012). Evaluation of endoscopic harmonic diverticulostomy. Laryngoscope, 122(6), 1297–1300. https://doi.org/10.1002/lary.23251
Whited, Chad, Walter T. Lee, and Richard Scher. “Evaluation of endoscopic harmonic diverticulostomy.Laryngoscope 122, no. 6 (June 2012): 1297–1300. https://doi.org/10.1002/lary.23251.
Whited C, Lee WT, Scher R. Evaluation of endoscopic harmonic diverticulostomy. Laryngoscope. 2012 Jun;122(6):1297–300.
Whited, Chad, et al. “Evaluation of endoscopic harmonic diverticulostomy.Laryngoscope, vol. 122, no. 6, June 2012, pp. 1297–300. Pubmed, doi:10.1002/lary.23251.
Whited C, Lee WT, Scher R. Evaluation of endoscopic harmonic diverticulostomy. Laryngoscope. 2012 Jun;122(6):1297–1300.
Journal cover image

Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

June 2012

Volume

122

Issue

6

Start / End Page

1297 / 1300

Location

United States

Related Subject Headings

  • Zenker Diverticulum
  • Ultrasonic Therapy
  • Treatment Outcome
  • Tensile Strength
  • Surgical Stapling
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Postoperative Complications
  • Otorhinolaryngology