(163) Effect of Tobacco Use on Zenker’s Diverticulotomy Outcomes

Introduction: To compare clinical outcomes in patients with and without history of tobacco use who underwent Zenker’s diverticulotomy.

Methods: A retrospective review of patients who underwent Zenker’s diverticulotomy (ZD) via an open stapler, rigid endoscopic CO2 laser, stapler or harmonic scalpel, and flexible endoscopic technique from January 2006 to December 2020 was performed. Data were abstracted for patient demographics, diverticular features, and rates of adverse events and symptomatic recurrence.

Results: Out of 424 patients, 147 (34.7%) had a history of tobacco use. No significant differences were noted between patients with and without history of tobacco use in age, race, body mass index, and Charlson Comorbidity Index. In univariable cross-sectional analysis, the likelihood of a post-operative adverse event (infection, bleeding, perforation, emergency department visit, readmission) was not found to be significantly different between patients with and without tobacco use history, even after adjustment for age, sex, and surgical approach. In Cox Proportional Hazards regression, tobacco use was not associated with increased risk of recurrence (p-value=0.93), even after correcting for age, sex, and type of surgery (p-value=0.30). Further analysis will compare outcomes for patients with active versus remote tobacco use.

Conclusions: There were no significant differences in post-operative adverse events or in recurrence of the Zenker’s diverticulum between patients with and without a history of tobacco use.