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Meta-Analysis
. 2014 May;150(5):750-3.
doi: 10.1177/0194599814521554. Epub 2014 Feb 4.

Carbon dioxide laser versus stapler-assisted endoscopic Zenker's diverticulotomy: a systematic review and meta-analysis

Noah P Parker  1 , Stephanie Misono
Affiliations
Meta-Analysis

Carbon dioxide laser versus stapler-assisted endoscopic Zenker's diverticulotomy: a systematic review and meta-analysis

Noah P Parker et al. Otolaryngol Head Neck Surg. 2014 May.

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.

Keywords: Zenker’s; carbon dioxide laser; diverticula; stapler.

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Conflict of interest statement

Disclosures

Competing interests: None.

Figures

Figure 1
Figure 1
Systematic review flow chart.
See this image and copyright information in PMC

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