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DOI: 10.1055/a-1024-5879
Safety and efficacy of submucosal tunneling endoscopic septum division for epiphrenic diverticula
Gefördert durch: National Natural Science Foundation of China 81770561Gefördert durch: National Natural Science Foundation of China 81470830
Gefördert durch: Special Diagnosis and Treatment Technology of Clinical Key Diseases LCZX201421
Gefördert durch: Innovation team CXTDA2017033
Publikationsverlauf
submitted 14. Dezember 2018
accepted after revision 07. August 2019
Publikationsdatum:
21. Oktober 2019 (online)
![](https://www.thieme-connect.de/media/endoscopy/201912/lookinside/thumbnails/17472_10-1055-a-1024-5879-1.jpg)
Abstract
Background Symptomatic epiphrenic diverticula are mostly treated with laparoscopic diverticulectomy. Our study aimed to demonstrate the safety and efficacy of submucosal tunneling endoscopic septum division (STESD) for treatment of symptomatic epiphrenic diverticula.
Methods Data from patients with epiphrenic diverticula who had undergone STESD were retrospectively reviewed. The parameters analyzed were the modified Eckardt score, total procedure time, length of hospital stay (LOS), number of clips used, adverse events, and patient satisfaction.
Results A total of eight patients (5 men; mean [standard deviation (SD)] age 66.25 [7.17] years) were enrolled in our study. The mean (SD) size of epiphrenic diverticula was 3.68 (1.59) cm. The mean (SD) procedure time was 52.87 (22.47) minutes, with a median number of six clips being applied. The modified Eckardt score significantly decreased post-procedure (P < 0.001). The mean (SD) LOS was 5.87 (0.83) days. No adverse events or symptom recurrences were reported.
Conclusion STESD is a safe and effective technique to be performed in the submucosal tunnel for the management of patients with epiphrenic diverticula.
* Equal first authors
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References
- 1 Herbella FA, Patti MG. Modern pathophysiology and treatment of esophageal diverticula. Langenbeck Arch Surg 2012; 397: 29-35
- 2 Aiolfi A, Scolari F, Saino G. et al. Current status of minimally invasive endoscopic management for Zenker diverticulum. World J Gastrointest Endosc 2015; 7: 87-93
- 3 Li QL, Chen WF, Zhang XC. et al. Submucosal tunneling endoscopic septum division: a novel technique for treating Zenkerʼs diverticulum. Gastroenterology 2016; 151: 1071-1074
- 4 Juliana Y, Xianhui Z, Xianglei Y. et al. An international study on the use of peroral endoscopic myotomy (POEM) in the management of esophageal diverticula: the first multicenter D-POEM experience. Endoscopy 2019; 51: 346-349
- 5 Zaninotto G, Portale G, Costantini M. et al. Long-term outcome of operated and unoperated epiphrenic diverticula. J Gastrointest Surg 2008; 12: 1485-1490
- 6 Eckardt AJ, Eckardt VF. Treatment and surveillance strategies in achalasia: an update. Nat Rev Gastroenterol Hepatol 2011; 8: 311-319
- 7 Aravinthan A, Nikolic M, Ouyang X. et al. The hidden cause of dysphagia – epiphrenic diverticulum and esophageal motility disorders. Can J Gastroenterol 2012; 26: 68-69
- 8 Herbella FAM, Patti MG. Achalasia and Epiphrenic Diverticulum. World J Surg 2015; 39: 1614
- 9 Rossetti G, Fei L, Del GG. et al. Epiphrenic diverticula mini-invasive surgery: a challenge for expert surgeons--personal experience and review of the literature. Scand J Surg 2013; 102: 129
- 10 Allaix ME, Borraez SB, Herbella FA. et al. Is resection of an esophageal epiphrenic diverticulum always necessary in the setting of achalasia?. World J Surg 2015; 39: 203-207
- 11 Herbella FAM, Dubecz A, Patti MG. Esophageal diverticula and cancer. Dis Esophagus 2012; 25: 153-158
- 12 Achim V, Aye RW, Farivar AS. et al. A combined thoracoscopic and laparoscopic approach for high epiphrenic diverticula and the importance of complete myotomy. Surg Endosc 2017; 31: 788-779
- 13 Perbtani Y, Suarez A, Wagh MS. Techniques and efficacy of flexible endoscopic therapy of Zenkerʼs diverticulum. World J Gastrointest Endosc 2015; 7: 206-212
- 14 Pescarus R, Shlomovitz E, Sharata AM. et al. Trans-oral cricomyotomy using a flexible endoscope: technique and clinical outcomes. Surg Endosc 2016; 30: 1784-1789
- 15 Costamagna G, Iacopini F, Bizzotto A. et al. Prognostic variables for the clinical success of flexible endoscopic septotomy of Zenkerʼs diverticulum. Gastrointest Endosc 2016; 83: 765-773