Introduction
Materials and Methods
Search Strategy
Inclusion Criteria
Exclusion Criteria
Data Extraction
Statistical Analysis
Study Quality
Results
Characteristics of Included Studies
Author | Year | Country | Total | Age (years) | Approach | Myotomy | Anti-reflux | F/Ua (months) | NOb
|
---|---|---|---|---|---|---|---|---|---|
Allaix et al.35
| 2015 | USA | 13 | 65 | Laparoscopy | 13 | 13 | 24 | 5 |
Altorki et al.18
| 1993 | USA | 17 | 65 | Open | 17 | 17 | 84 | 5 |
Bagheri et al.23
| 2014 | Iran | 17 | 39 | Open | 12 | 0 | 12 | 5 |
Benacci et al.8
| 1993 | USA | 33 | 65 | Open | 23 | 6 | 83 | 6 |
Bowman et al.11
| 2015 | USA | 44 | 70 | Laparoscopy | 44 | 44 | 39 | 6 |
Castrucci et al.21
| 1998 | Italy | 27 | 55 | Open | 22 | 17 | 47 | 4 |
DJourno et al.20
| 2009 | Canada | 23 | 58 | Open | 23 | 22 | 61 | 5 |
Fekete and Vonns10
| 1992 | France | 27 | 63 | Open | 15 | 14 | 6 | 5 |
Fumagalli et al.33
| 2012 | Italy | 30 | 62 | Laparoscopy | 30 | 30 | 52 | 5 |
Gonzalez-Calatayud et al.12
| 2014 | Spain | 6 | 64 | Laparoscopyc
| 6 | 6 | 62 | 5 |
Hauge et al.13
| 2014 | Norway | 11 | 60 | Both | 3 | 3 | 27 | 6 |
Hudspeth et al.24
| 1993 | USA | 9 | 62 | Open | 6 | 0 | 36 | 5 |
Jordan and Kinner25
| 1999 | USA | 19 | 59 | Open | 13 | 4 | – | 4 |
Klaus et al.6
| 2003 | USA | 11 | 68 | Laparoscopyc
| 10 | 10 | 26 | 5 |
Macke et al.26
| 2015 | USA | 57 | 71 | Laparoscopyc
| 47 | 24 | 21 | 6 |
Matthews et al.27
| 2003 | USA | 5 | 64 | Laparoscopyc
| 5 | 4 | 16 | 6 |
Melman et al.32
| 2009 | USA | 13 | 67 | Laparoscopy | 13 | 12 | 14 | 6 |
Nehra et al.7
| 2002 | USA | 18 | 66 | Open | 17 | 17 | 24 | 5 |
Rossetti et al.30
| 2013 | Italy | 21 | 59 | Laparoscopy | 21 | 21 | 78 | 6 |
Soares et al.29
| 2011 | USA | 23 | 57 | Both | 21 | 23 | 34 | 6 |
Streitz et al.22
| 1992 | USA | 16 | 62 | Open | 13 | 0 | 84 | 5 |
Tedesco et al.34
| 2005 | USA | 7 | 73 | Laparoscopy | 7 | 7 | 60 | 4 |
van der Peet et al.28
| 2001 | Netherlands | 5 | 58 | Laparoscopyc
| 2 | 0 | – | 4 |
Varghese et al.19
| 2007 | USA | 35 | 71 | Open | 33 | 34 | 45 | 6 |
Zaninotto et al.31
| 2012 | Italy | 24 | 61 | Laparoscopy | 21 | 24 | 96 | 5 |
Patient Demographics and Diagnosis
Indications for Surgery
Surgical Approach
Management of Diverticulum
Myotomy
Fundoplication
Outcomes
Staple Line Leak
Author | Total | Diverticulectomy | Leak | Morbidity | Reoperation | Mortality | Recurrence |
---|---|---|---|---|---|---|---|
Allaix et al.35
| 13 | 6 (46.2) | 1 (15.7) | 1 (7.7) | 0 | 0 | 0 |
Altorki et al.18
| 17 | 14 (82.4) | 1 (7.1) | 1 (5.9) | 0 | 1 (5.9) | 0 |
Bagheri et al.23
| 17 | 13 (76.5) | 1 (7.7) | 3 (17.6) | 0 | 0 | 0 |
Benacci et al.8
| 33 | 32 (97.0) | 6 (18.8) | 11 (33.3) | 2 (6.1) | 3 (9.1) | 0 |
Bowman et al.11
| 44 | 44 (100.0) | 8 (18.2) | 33 (75.0) | 0 | 0 | 0 |
Castrucci et al.21
| 27 | 17 (63.0) | 2 (11.8) | 3 (11.1) | 2 (7.4) | 2 (7.4) | 0 |
DJourno et al.20
| 23 | 13 (56.5) | 0 | 2 (8.7) | 0 | 0 | 0 |
Fekete and Vonns10
| 27 | 23 (85.2) | 2 (8.7) | 5 (18.5) | 1 (3.7) | 3 (11.1) | 2 (7.4) |
Fumagalli et al.33
| 30 | 30 (100.0) | 1 (3.3) | 2 (6.7) | 1 (3.3) | 0 | 0 |
Gonzalez-Calatayud et al.12
| 6 | 6 (100.0) | 2 (33.3) | 2 (33.3) | 0 | 0 | 0 |
Hauge et al.13
| 11 | 9 (81.2) | 3 (33.3) | 3 (27.3) | 2 (18.2) | 0 | 0 |
Hudspeth et al.24
| 9 | 9 (100.0) | 1 (11.1) | 1 (11.1) | 1 (11.1) | 0 | 0 |
Jordan and Kinner25
| 19 | 16 (84.2) | 1 (6.3) | 1 (5.3) | 0 | 0 | 0 |
Klaus et al.6
| 11 | 6 (54.5) | 1 (16.7) | 2 (18.2) | 1 (9.1) | 0 | 0 |
Macke et al.26
| 57 | 57 (100.0) | 4 (7.0) | 18 (31.6) | 4 (7.0) | 1 (1.8) | 0 |
Matthews et al.27
| 5 | 5 (100.0) | 0 | 0 | 0 | 0 | 0 |
Melman et al.32
| 13 | 13 (100.0) | 1 (7.7) | 2 (15.4) | 1 (7.7) | 0 | 0 |
Nehra et al.7
| 18 | 14 (77.8) | 1 (7.1) | 3 (16.7) | 2 (11.1) | 1 (9.1) | 0 |
Rossetti et al.30
| 21 | 21 (100.0) | 5 (23.8) | 6 (28.6) | 0 | 1 (4.8) | 0 |
Soares et al.29
| 23 | 23 (100.0) | 1 (4.3) | 5 (21.7) | 1 (4.3) | 1 (4.3) | 0 |
Streitz et al.22
| 16 | 16 (100.0) | 1 (6.3) | 6 (37.5) | 0 | 0 | 0 |
Tedesco et al.34
| 7 | 7 (100.0) | 1 (14.3) | 1 (14.3) | 1 (14.3) | 0 | 0 |
van der Peet et al.28
| 5 | 5 (100.0) | 1 (20.0) | 1 (20.0) | 1 (20.0) | 0 | 1 (20.0) |
Varghese et al.19
| 35 | 33 (94.3) | 2 (6.1) | 5 (14.3) | 1 (2.9) | 1 (2.9) | 0 |
Zaninotto et al.31
| 24 | 24 (100.0) | 4 (16.7) | 6 (25.0) | 0 | 0 | 0 |
Surgical approach | Pooled staple line leak rates, (95% c.i.) |
p value |
---|---|---|
Open | 11.3 (8.4–14.2) | 0.347 |
Minimally invasive | 15.2 (11.4–19.0) | |
Myotomy | 12.4 (9.2–15.6) | 0.002 |
No myotomy | 26.1 (18.3–33.9) | |
Anti-reflux | 14.7 (10.8–18.5) | 0.45 |
No anti-reflux | 13.3 (9.9–16.7) |
Treatment Success
Surgical approach | Pooled treatment success rates (95% c.i.) |
p value |
---|---|---|
Open | 87.4 (81.8–93.0) | 0.56 |
Minimally invasive | 89.6 (84.6–94.5) | |
Diverticulectomy | 85.0 (80.9–89.1) | 0.02 |
No diverticulectomy | 65.4 (55.6–75.2) |