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Endoscopic treatment for Zenker's diverticulum: long-term results (with video).

Abstract：

BACKGROUND:Diverticulotomy is a standard treatment for Zenker's diverticulum (ZD). This technique was adapted to flexible endoscopy. OBJECTIVE:We report our long-term results of ZD treatment by using flexible endoscopy assisted by a soft diverticuloscope. DESIGN:Follow-up study. SETTING:Academic hospital. Tertiary-care referral center. PATIENTS:A total of 150 patients with ZD were treated with the same technique from July 2002 to June 2011. INTERVENTION:The procedure was performed by using a soft diverticuloscope to expose the septum, which was then cut with a needle-knife, and the procedure was completed by use of endoclip placement at the bottom of the section. MAIN OUTCOME MEASUREMENTS:Symptoms were compared before and after the procedure, 1 month later, and at the end of follow-up. RESULTS:The median size of the ZD was 3 cm (range 1-8 cm). The endoscopic incision was performed in one session (range 1-3 sessions). Clinical success at 1 month was 90.3%. Four adverse events (2.2%) occurred and were managed conservatively. Symptom evaluation at 1 month and at the end of follow-up was obtained in 103 and 134 patients, respectively. The dysphagia score dropped from 1.88 to 0.29 (P < .01) and 0.34 (P < .05) at 1 month and at the end of follow-up, respectively (median 43 months, range 13-121 months). Regurgitations and chronic cough dropped from 73% and 27% to 11% and 2% at the end of follow-up, respectively. Symptom recurrence occurred in 31 patients (23.1%); among them 23 had a second treatment, and only 5 required a third one. LIMITATIONS:Retrospective study, single center. CONCLUSION:Endoscopic incision of ZD by using a soft diverticuloscope and completed by endoclips is safe and efficient at short term and long term.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Huberty V,El Bacha S,Blero D,Le Moine O,Hassid S,Devière J

doi

10.1016/j.gie.2012.12.008

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

701-7

issue

5

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(12)03061-1

journal_volume

77

pub_type

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