Perioperative Outcomes in Zenker Diverticulum Surgery

Introduction: To understand the presentation, risk factors, and outcomes of Zenker's Diverticulum (ZD) patients undergoing endoscopic or open surgery. To investigate the association between patient characteristics and perioperative outcomes in Zenker's Diverticulum surgery.

Methods: Retrospective chart review of ZD procedures at a University Hospital from 2005 to 2022. Data was collected on 114 variables: demographics, medical history, preoperative risk factors, procedure, postoperative occurrences, discharge, readmission, and recurrence. Preoperative risk factors were evaluated using criteria from the American College of Surgeons. Data analysis was performed using Stata.

Results: A total of 184 procedures were reviewed, with 77 females (42%) and 107 males (58%) in the patient sample. The majority of patients were white (85.3%) and spoke English (99%). The mean age at presentation was 71 (SD 12) years, and the three most common preoperative symptoms were dysphagia (91%), weight loss (19%), and hoarseness (14%). The median length of stay was one day, with 1% staying more than 30 days. The most common postoperative complication was wound disruption (2.7%), with all other complications at 1% or less. Overall, 89% of patients had partial or full symptom resolution. No patient characteristics were found to predict recurrence. However, unplanned conversions (excluding open surgery) negatively predicted symptom resolution (OR 0.05, p=0.02), and symptom duration positively predicted symptom resolution (OR 2.13, p=0.05).

Conclusions: Zenker's Diverticulum surgery had low rates of complications and high rates of symptom resolution. No risk factors for recurrence were identified, but unplanned conversions and symptom duration were found to affect symptom resolution