In:
Diseases of the Esophagus, Oxford University Press (OUP), Vol. 31, No. Supplement_1 ( 2018-09-01), p. 61-61
Abstract:
Flexible endoscopic septum division (FESD) is an established natural orifice endoscopic technique for the treatment of symptomatic Zenker's diverticulum (ZD). We report about the experience with FESD at our center. Methods Consecutive patients undergoing FESD were included in the study. Inclusion criteria were craniocaudad length of the septum of at least 20mm. FESD was done with high frequency cautery in an ERCP cut modus. Postoperative fluid intake was allowed for the first 3 days followed by semisolid food for 7 days. Data were collected prospectively. Swallowing symptoms were assessed preoperatively and at follow-up by using the Eckardt score. Results Since 2014 52 patients were treated for ZD. Among them 47 patients consecutively undergoing FESD were included. Five minute arterial bleedings were managed intraoperatively by cautery forceps. 2 suspected perforations were clipped and oral nutrition was delayed for 2 days. All patients but one reported immediate success after FESD (97,8%), 8 patients temporarily had mild swallowing discomfort. Postoperative adverse events were fever (n = 3), pneumonia (n = 3), neck abscess (n = 2) requiring transcervical opening and drainage. Median follow up period was 20 months. Until follow up 30 patients (until abstract deadline) were evaluated: one patient underwent redo FESD for recurrent dysphagia 12 mo after FESD. A second patient with symptomatic mild recurrence did not need redo FESD so far, resulting in a recurrence rate of 6,7% (2/30). Both patients with recurrence initially had a septum shorter than 25mm. Conclusion FESD is an effective minimally invasive natural orifice treatment for symptomatic ZD with immediate symptomatic relief. No recurrence has been observed after intermediate follow-up, if length of myotomy was longer than 2cm. Long term results are awaited. Disclosure All authors have declared no conflicts of interest.
Type of Medium:
Online Resource
ISSN:
1120-8694
,
1442-2050
DOI:
10.1093/dote/doy089.PS01.040
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2018
detail.hit.zdb_id:
2004949-3
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