Endoscopic stapling for pharyngeal pouch: does it make the cut?

Aim The aim of this study was to describe the local experience of endo-scopic stapling for pharyngeal pouch with analysis of application, outcome,morbidity and patient satisfaction.Method s All patients admitted for endoscopic stapling between 1998 and2002 by surgeons from the Royal Adelaide Hospital and Flinders MedicalCentre were identified. Their medical records were reviewed for clinical andoperative details.A structured phone interview was used to evaluate symptom resolution andpatient satisfaction. The Likert scale was used to assess the impact of pre andpost operative symptoms upon quality of life.Results A total of 31 patients were identified. The mean age of thegroup was 75 (35–91) and the mean ASA score was 2.5. In 4 patients theprocedure was abandoned, 3 because of inability to pass the diverticulo-scope and 1 because the pouch was too small. Standard open surgery wasundertaken in these patients. Of the completed 27 endoscopic procedures,interview follow up was available in 23 with a mean follow up of 17 (2–68)months. Outcome was very good or excellent in 21 (91%), with significantsymptom resolution and reduced Likert scores. Patient satisfaction washigh. Three patients had undergone previous pouch surgery and endoscopicstapling was straightforward in these patients. Recurrence of a sympto-matic pouch occurred in 3 patients. There was no significant morbidityrelated to the procedure.Conclusions The early experience of endoscopic stapling for pharyngealpouch in Adelaide is encouraging. The procedure is very quick, widely appli-cable and achieves excellent symptom control and can be undertaken withminimal morbidity.