D. J. Gross1,2, B. Zangbar-Sagbeh1, M. Skovgard2,4, E. Kao1, E. Chang3, S. Arora1,3, A. Reyes3 1State University of New York Downstate Medical Center,Surgery,New York, NY, USA 3Kings County Hospital Center,Brooklyn, NY, USA 4Weill Cornell Medical College,New York, NY, USA
Introduction:
Zenker’s diverticulum are false diverticulum through Killian’s triangle with an estimated incidence of two per 100,000 patients per year. Surgical management of myotomy with/out diverticulectomy was the standard since its discovery; however, endoscopic division of the cricopharyngeus muscle has emerged as a viable option. While multiple studies have established equivalent outcomes among techniques, no study has evaluated the difference in outcomes by practitioners.
Methods:
ACS NSQIP (2015-2016) Databases were queried for patients with Zenker's Diverticulum diagnosis. We used ICD 10 code (K22.5). Patients were divided in 3 groups based on the subspecialty performing the procedure and we then subsequently extracted demographics, the type of the procedure, and complications. Univariate analysis was performed for outcomes of interest, time of operation, hospital length of stay, discharge to home, morbidity and mortality.
Results:
There were no mortalities among any groups. Otolaryngologists (ENT) had the lowest estimated incidence of morbidity and the shortest operating times; but these differences did not reach statistical significance. General surgeons had slightly increased operative time as compared to their ENT counterparts, but increased estimated incidence of morbidity and the highest of all groups estimated mortality; but, again, this did not reach statistical significance. Thoracic surgeons had the highest operative time, lowest estimated mortality and equal incidence of estimated morbidity to their general surgery counterparts. The length of stay (LOS) was the only outcome of interest which demonstrated a statistically significant difference among groups; with thoracic surgeons having two additional inpatient days compared to the ENT group and one extra day compared to the general surgery group.
Discussion:
In this pooled observation study, we found no major differences in morbidity and mortality among surgical specialties. We did see a difference in operative times among groups however this did not reach statistical significance. LOS was higher in the thoracic surgeon group as compared to ENT and general surgeon groups by 2 and 1 day(s), respectively. These findings suggest the role for standardization of post-operative regimens as a cost saving measure.
