Rath Timo, Siebler Jürgen, Neurath Markus F, Nägel Andreas
Department of Medicine 1, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, University Hospital Erlangen, Erlangen, Germany.
Endosc Int Open. 2018 Jun;6(6):E659-E663. doi: 10.1055/a-0603-3357. Epub 2018 May 25.
Although several endoscopic techniques have been described for Zenker's diverticulotomy, no standardized endoscopic approach has been established in clinical routine to date. This study aimed to assess the efficacy and safety of endoscopic diverticulotomy using the Clutch Cutter.
Cricopharyngeal myotomy was performed in six prospectively enrolled patients with symptomatic Zenker's diverticulum, using the Clutch Cutter. Procedural details such as duration, complications, and technical success were recorded and compared to the outcomes of 15 patients who received needle-knife-based myotomy.
Myotomy with the Clutch Cutter was feasible in all six patients with complete diverticulotomy in a single session in all patients. Mean procedure time of the Clutch Cutter myotomy was 19 minutes without major complications. During follow-up, one patient had diverticulum recurrence after 10 months, which was successfully re-treated. Mean procedure time with the needle-knife was 43 minutes and a mean of 2.7 myotomy sessions was required for complete diverticulotomy.
Endoscopic diverticulotomy using the Clutch Cutter is safe, effective, and fast. Larger studies comparing myotomy using the Clutch Cutter with other endoscopic techniques are highly warranted.
尽管已有多种内镜技术用于Zenker憩室切开术，但迄今为止临床常规中尚未建立标准化的内镜手术方法。本研究旨在评估使用抓持切割器进行内镜憩室切开术的有效性和安全性。
对6例前瞻性纳入的有症状的Zenker憩室患者使用抓持切割器进行环咽肌切开术。记录手术持续时间、并发症和技术成功率等手术细节，并与15例接受针刀肌切开术的患者的结果进行比较。
所有6例患者使用抓持切割器进行肌切开术均可行，所有患者均在单次手术中完成憩室切开术。抓持切割器肌切开术的平均手术时间为19分钟，无重大并发症。随访期间，1例患者在10个月后憩室复发，经再次治疗成功。针刀肌切开术的平均手术时间为43分钟，完全憩室切开术平均需要2.7次肌切开术。
使用抓持切割器进行内镜憩室切开术安全、有效且快速。非常有必要开展更大规模的研究，比较使用抓持切割器进行肌切开术与其他内镜技术。
