Surgical Management of Killian-Jamieson Diverticulum: A Systematic Review of Open and Endoscopic Outcomes.

Objective

To systematically review surgical management of Killian-Jamieson diverticulum (KJD) and compare outcomes of open and endoscopic approaches, focusing on symptom control, perioperative recovery, and recurrent laryngeal nerve (RLN) morbidity. DATA SOURCES PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were searched from inception to December 1, 2025, with additional Google Scholar and reference screening. REVIEW

Methods

Following PRISMA 2020, 2 reviewers independently screened records, selected studies, and extracted patient-level data on surgically treated KJD. Eligible reports described open transcervical or endoscopic treatment with postoperative outcomes. Study quality was appraised with Joanna Briggs Institute checklists, and data were synthesized descriptively by approach.

Results

Forty-one studies including 86 patients were analyzed, 47 treated endoscopically and 39 with open surgery. Overall clinical success, defined as symptom resolution or improvement without reintervention, was high in both groups with a failure rate of 3.5%. Complete resolution was reported more often after open surgery, whereas endoscopic treatment more frequently yielded partial improvement. In patients with perioperative data, endoscopic approaches were associated with earlier oral intake and shorter hospital stay, and no mortality was reported.

Conclusion

Both open and endoscopic surgery for KJD achieve favorable symptom outcomes with low complication rates, and current evidence does not show clear superiority of one approach. Given the rarity of KJD and the small size of existing series, this review provides the most comprehensive synthesis to date of surgical outcomes and perioperative risks across open and endoscopic techniques.