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首页> 外文期刊>Endoscopy International Open >Endoscopic treatment of Zenker?s diverticulum by complete septotomy: initial experience in 19 patients
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Endoscopic treatment of Zenker?s diverticulum by complete septotomy: initial experience in 19 patients

机译：通过完全静脉构的ZENKER的内镜治疗ZENKER？S憩室的憩室：19例患者的初始经验

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Background and study aims?Endoscopic treatment of Zenker’s Diverticulum (ZD) using a flexible endoscope and a diverticuloscope consists of myotomy of the cricopharyngeus muscle, sparing the lower part of the diverticular septum. However, recurrence occurs in up to 54?% of patients at 4 years. We assessed the feasibility and safety of a complete septotomy in endoscopic treatment of ZD. Patients and methods?We conducted a retrospective analysis of a prospectively collected database at a single referral center. All consecutive patients treated by complete resection of the diverticular wall were included. The endoscopic technique used a distal attachment cap and division of the ZD septum using a Dual Knife or a Triangle Tip knife in endocut mode, until the esophageal muscularis propria was seen and no residual diverticulum remained. Symptoms were evaluated using the Augsburger questionnaire. Results?Nineteen patients, 10 of whom were men with mean age 79?±?12 years, were treated by complete septotomy for a symptomatic ZD with a median size of 2.5?cm (range 1–5?cm). The clinical success rate was 100?% and the complication rate was 10?% (one pneumonia and one atrial fibrillation). Median hospital stay was 2 days (range 1–3 days). On Day 1 esophagogram, no extraesophageal contrast leakage was seen, periesophageal COsub2/sub was still visible in two patients, and complete ZD regression was seen in 63?% of patients. The 6-month clinical success rate was 100?%, with two patients lost to follow-up, and a median symptom score of 0 (range 0–4). After a mean ± SD follow-up of 9?±?5 months, the clinical success rate was 94?% (16/17). Conclusion?Complete endoscopic septotomy is a feasible and safe therapeutic modality in patients with symptomatic ZD that does not require use of a diverticuloscope, and with good short-term efficacy. The complete regression of the diverticulum observed on Day 1 in 63?% of patients could be a marker of long-term clinical success.
机译：背景和研究旨在使用柔性内窥镜和憩室镜的内镜治疗Zenker的憩室（ZD），并且憩室镜包括肌肉肌肉肌肉的肌肌瘤，从憩室隔膜的下部施加。但是，在4年内患者的复发发生在最多54岁以下。我们评估了完全孤独术在内镜治疗ZD中的可行性和安全性。患者和方法？我们对一名推荐中心进行了对期收集的数据库进行了回顾性分析。包括通过完全切除憩室壁治疗的所有连续患者。内窥镜技术使用了使用双刀或三角形尖刀在内皮模式下的远端附接帽和ZD隔膜的分割，直到看到食道肌肉血管肝癌，并且没有残留憩室仍然存在。使用Augsburger调查问卷评估症状。结果？十九名患者，其中10名是男性，平均年龄为79岁？临床成功率为100？％，并发症率为10？％（一个肺炎和一个心​​房颤动）。中位医院住宿时间为2天（范围1-3天）。在第1天的食管照片中，没有看到异味对比渗漏，在两名患者中仍然可见过化食管CO 2 ，并在63名患者中看到完整的ZD回归。 6个月的临床成功率为100？％，两名患者失去随访，中位数症状得分为0（范围0-4）。平均±SD随访9？±5个月后，临床成功率为94？％（16/17）。结论？完全内镜下近似镜术是患有症状ZD患者的可行和安全的治疗方式，其不需要使用憩室镜，并且具有良好的短期疗效。在63名患者的第1天观察到憩室的完全回归可能是长期临床成功的标志。

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