Cap-Assisted Endoscopic Septotomy of Zenker's Diverticulum: Early and Long-Term Outcomes.

Szczegóły
Abstrakt

Tytuł:: Cap-Assisted Endoscopic Septotomy of Zenker's Diverticulum: Early and Long-Term Outcomes.
Autorzy:: Repici A; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Cappello A; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Spadaccini M; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Nicoletti R; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Carrara S; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Fugazza A; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Galtieri PA; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Lamonaca L; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Romana C; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Badalamenti M; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Di Leo M; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Pellegatta G; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Ferrara EC; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Anderloni A; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Maselli R; Endoscopy Unit, Humanitas Clinical and Research Center, RCCS, Milano, Italy.
Źródło:: The American journal of gastroenterology [Am J Gastroenterol] 2021 Sep 01; Vol. 116 (9), pp. 1853-1858.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: <2019-> : [Philadelphia, PA] : Wolters Kluwer Health
Original Publication: New York, Elsevier Science, -2003.
MeSH Terms:: Deglutition Disorders/*surgery
Endoscopy/*methods
Zenker Diverticulum/*surgery
Aged ; Aged, 80 and over ; Databases, Factual ; Deglutition Disorders/etiology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Zenker Diverticulum/complications
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Molecular Sequence:: ClinicalTrials.gov NCT03948438
Entry Date(s):: Date Created: 20210708 Date Completed: 20210913 Latest Revision: 20230718
Update Code:: 20240105
DOI:: 10.14309/ajg.0000000000001356
PMID:: 34236338
: Czasopismo naukowe

Introduction: Multiple therapeutic modalities including surgery and rigid and flexible endoscopy have been adopted to manage Zenker's diverticulum (ZD). Minimally invasive flexible endoscopic septotomy (FES) techniques have been increasingly favored over the past 20 years; however, long-term data are still scanty. The aim of this study is to evaluate early and long-term outcomes of FES for naive ZD in a single-center setting.
Methods: From 2010 to 2017, ZD patients treated with FES were included in a prospectively maintained database (NCT03948438). Those who had already been treated surgically or endoscopically were excluded from the analysis. The Dakkak and Bennett dysphagia scale was used to rate the dysphagia. Persistent complete or near-complete resolution of symptoms (Dakkak and Bennett 0 or 1) was defined as clinical success. Postprocedural adverse events were reported according to ASGE lexicon.
Results: Overall, 256 consecutive patients were treated. Mean pouch size was 29.8 ± 11.3 mm. The procedure was successfully completed in all scheduled patients, with an early clinical success of 96.1%. Adverse events occurred in 3.5% (9/256) of patients. Eight of them were mild/moderate with no fatal events, whereas one patient required surgery. Recurrences occurred in 31.3% (80/256) of treated patients after a mean time of 9 ± 3 months and 95% of recurrences were treated by a second FES. At an average follow-up of 5.5 years, 95.3% of patients were asymptomatic after a mean number of 1.3 procedures.
Discussion: FES is a safe and effective treatment modality for patients with ZD. Recurrence rate is significant; however, endoscopic reintervention is associated with long-term relief of dysphagia.
(Copyright © 2021 by The American College of Gastroenterology.)

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