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.