Carbon Dioxide Laser Versus Stapler-Assisted Endoscopic Zenker's Diverticulotomy: A Systematic Review and Meta-Analysis. (May 2014)

• Record Type: Journal Article
• Authors: Parker, Noah P.; Misono, Stephanie
• Is Part Of: Otolaryngology--head and neck surgery. Volume 150:Number 5(2014:May)
• Page Start: 750
• Page End: 753
• Publication Date: 2014-05
• Subjects: Zenker's -- diverticula -- carbon dioxide laser -- stapler; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814521554
• Languages: English
• ISSNs: 0194-5998

Abstract

To evaluate outcomes following endoscopic management of Zenker's diverticula using a carbon dioxide laser (CO2 ) or stapler-assisted technique, a systematic review and meta-analysis were conducted. Seven retrospective, uncontrolled case series including 391 procedures met selection criteria. No higher quality studies were identified. Outcomes favoring the stapler technique included a shorter duration of nil per os (NPO) status (2 studies), length of hospitalization (LOH, 2 studies), and fewer postoperative fevers and abnormal chest x-rays (1 study). Outcomes favoring the CO2 technique included greater improvement in postoperative dysphagia and regurgitation scores (2 studies) and a lower revision rate (1 study). Meta-analysis demonstrated increased nondental complications in the CO2 group (odds ratio 3.81; 95% confidence interval, 1.37-10.59; P = .01) but no difference in duration of NPO ( P = .06), LOH ( P = .07), overall complications ( P = .08), dental complications ( P = .57), major complications ( P = .38), or revision surgery ( P = .82). Implications are limited by the quality of studies identified.