Surgical management of recurrent Zenker's diverticulum: A multi-institutional cohort study

This study identifies how recurrent Zenker's diverticula are treated. A retrospective chart review was performed from four tertiary referral academic voice and swallowing centers to identify individuals who underwent surgery for recurrent Zenker's diverticulum. Demographic data, surgical modalities for primary and revision surgery, symptoms pre and post revision and complications were recorded. 56 individuals met inclusion criteria. Primary surgery was open in 30.3% (n = 17) and endoscopic in 69.6% (n = 39). Revision surgery was performed via an open approach in 37.5% of cases (N = 21) and via an endoscopic approach in 62.5% of cases (N = 35). Revision surgical technique was based on pouch size, patient age and comorbidities, as well as patient and surgeon preference. There were no major complications and few minor complications. Zenker's diverticulum symptoms can recur regardless of primary treatment modality. Both endoscopic and open approaches can safely treat recurrent Zenker's diverticula. •Recurrent Zenker's diverticulum is not uncommon•An open transcervical approach has commonly been advocated for revision Zenker's diverticulum surgery•Recent studies have indicated that endoscopic approaches can be employed for revision Zenker's diverticulum surgery•Age of patient, size of recurrent pouch, or initial modality of surgery did not dictate approach in revision Zenker's diverticulum surgery•Regardless of modality used, revision Zenker's diverticulum is safe