Transoral stapling for Zenker diverticulum: Effect of the traction suture-assisted technique on long-term outcomes

Background: Long-term outcomes and predictors of success after transoral stapling for Zenker diverticulum are still unclear. Methods: Between 2001 and 2010, 91 patients with Zenker diverticulum underwent transoral stapling under general anesthesia. Since 2008, the technique was modified by applying traction sutures to ease engagement of the common septum inside the stapler jaws. Perioperative variables, distribution of symptoms, and outcome of surgery were analyzed. Long-term results were compared between patients undergoing standard versus modified technique of transoral stapling. Results: The transoral approach was successfully completed in 79 (86.8 %) patients with a median age of 74 years. Overall morbidity was 5 %, and there was no mortality. The median length of hospital stay was 2 days. Six patients were lost to follow-up. After a median followup of 53 (range, 12-114) months, an improvement of dysphagia and regurgitation scores (p