Safety and efficacy of submucosal tunneling endoscopic septum division for epiphrenic diverticula

Xuan Li; Weifeng Zhang; Juliana Yang; Xiaoyong Wang; Yini Dang; Bin Hu; Qiang Cai; Pinghong Zhou; Guoxin Zhang

doi:10.1055/a-1024-5879

Safety and efficacy of submucosal tunneling endoscopic septum division for epiphrenic diverticula

Endoscopy. 2019 Dec;51(12):1141-1145. doi: 10.1055/a-1024-5879. Epub 2019 Oct 21.

Authors

Xuan Li^#^{1

2}, Weifeng Zhang^#^{1

2}, Juliana Yang³, Xiaoyong Wang⁴, Yini Dang^{1

2}, Bin Hu⁵, Qiang Cai⁶, Pinghong Zhou⁷, Guoxin Zhang^{1

2}

Affiliations

¹ Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
² Department of Gastroenterology, The First School of Clinical Medicine of Nanjing Medical University, Nanjing, China.
³ Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA.
⁴ Department of Gastroenterology, Changzhou NO.2 People's Hospital, Changzhou, China.
⁵ Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.
⁶ Advanced Endoscopy Fellowship, Emory University School of Medicine, Atlanta, Georgia, USA.
⁷ Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital Fudan University, Shanghai, China.

^# Contributed equally.

PMID: 31634922
DOI: 10.1055/a-1024-5879

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
China
Deglutition Disorders / diagnosis
Deglutition Disorders / etiology
Diverticulum, Esophageal* / complications
Diverticulum, Esophageal* / diagnosis
Diverticulum, Esophageal* / physiopathology
Diverticulum, Esophageal* / surgery
Esophageal Achalasia* / complications
Esophageal Achalasia* / diagnosis
Esophagoscopy* / adverse effects
Esophagoscopy* / methods
Female
Heartburn / diagnosis
Heartburn / etiology
Humans
Male
Middle Aged
Myotomy* / adverse effects
Myotomy* / methods
Outcome and Process Assessment, Health Care
Retrospective Studies
Zenker Diverticulum* / complications
Zenker Diverticulum* / diagnosis
Zenker Diverticulum* / physiopathology
Zenker Diverticulum* / surgery