Abstract

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