Systemic inflammatory response after endoscopic surgery of Zenker’s diverticulum

Zenker’s diverticulum can be treated with a carbon dioxide laser or linear stapling device. A retrospective study on patients undergoing electivesurgery for Zenker`s diverticulum with carbon dioxide laser or stapler was performed to analyse possible differences in inflammatoryresponses during the postoperative period. Leucocyte counts and C-reactive protein levels in peripheral blood were measured before and ondays 1, 2, 3 and 5 after the operation. Statistical analysis was performed using the Mann-Whitney U-test. Of 34 patients, 16 were treated bylaser and 18 by stapler. Age, sex ratio and ASA grade did not differ between the groups. Postoperative leukocytosis was significantly milderin the stapler group compared with patients who were treated by carbon dioxide laser. The mean C-reactive protein (CRP) level on day 1,2 and 3 after surgery was significantly higher in the CO2 laser group than in the stapler group. Leukocyte counts recovered on day 3 aftersurgery in both groups while CRP levels did not decline to preoperative levels at day 5 after the operation in either group. No inflammatorycomplications such as mediastinitis or pneumonia occurred. In conclusion, the inflammatory response in the early period after carbondioxide laser diverticulotomy of Zenker’s diverticulum is higher than after stapler-assisted surgery of Zenker’s diverticulum.