Evaluate the Safety and Efficacy of Outpatient Endoscopic Diverticulotomy

All patients who had an endoscopic Diverticulotomy over an 8-year period were included. Retrospective chart review was conducted to obtain patient demographic and procedural and post-procedural management data. Any complications during and after the procedure were included. 

38 patients were included with 46 endoscopic diverticulotomies performed. 24 patients (63.2%) were male, and median age was 78.5 (range 51 to 103) at the time of procedure. Majority of patients (73.7%) had a Charlson Comorbidity score of 3 or higher. Only 1 patient was an active smoker, and none had excessive alcohol use history. Dysphagia, regurgitation, and heart burn were most common symptoms present at the time of referral (91.3%, 71.7%, and 58.7%, respectively). 10 (21.7%) had previous interventions for ZD – 8 of which were with endoscopic diverticulotomy. 12 procedures (26.1%) were performed under conscious sedation and 34 (73.9%) under general anesthetic. 5 patients (10.9%) had intraprocedural bleeding, which did not require transfusions. 3 patients (6.8%) developed subcutaneous emphysema within 2 hours post-procedure and were managed conservatively without further endoscopic or surgical intervention. 33 patients (71.7%) were discharged on the same day of procedure, with an additional 6 (13.0%) discharged within 2 days post-procedure. Median follow-up was 74 days (range 0-2472 days). 

Endoscopic diverticulotomy is a safe procedure for the management of Zenker’s Diverticula. Patients with immediate complications, including intraprocedural bleeding or presence of subcutaneous emphysema within 2 hours post-procedure, were associated with hospital stay longer than 1 day. None of the patients developed late complications or required readmission within 30 days of discharge. Therefore, outpatient ZD management is effective in both patient management and resource allocation.