Long term self-reported post-operative outcomes of endoscopic and open pharyngeal pouch repairs

Abstract

Background: In recent years, there has been a shift to treating pharyngeal pouches endoscopically, however few studies report the long-term functional outcomes of patients following these repairs. Our aim is to investigate and compare the self-reported long-term functional outcomes of endoscopic and open pharyngeal pouch repair. Methods: A retrospective cohort analysis was performed using patient records to identify patients who had undergone either an open or endoscopic pharyngeal pouch repair from 2002-2018. Patients were then contacted and interviewed regarding their current swallowing status according to the M.D. Anderson Dysphagia Inventory (MDADI). Results: Of 185 identified, a total of 73 (37 female, mean age 77.4±10 years) participants were interviewed. Sixteen patients had undergone an open repair, and 57 endoscopic repair. Mean time interval between surgery and completion of interview was four years and three months (range, 3 months – 14 years 6 months). Overall mean global score for MDADI was 76.2±15 across all participants, 76.1±14.4 for endoscopic repair participants, and 76.4±17.9 for open repair participants. A Mann-Whitney U test comparing global MDADI of both procedure types was non-significant U =445, P=0.883, two-tailed. Conclusions: These findings suggest that decisions as to which surgical technique to select for pharyngeal pouch repair may be made according to surgical preference or other considerations other than concern over long-term patient swallowing outcomes. Our results indicate there is no statistically significant difference between endoscopic versus open pharyngeal pouch repair with regards to long-term patient-reported swallowing function.