Pop Anamaria, Tantau Alina, Tefas Cristian, Groza Andrei, Tantau Marcel
Prof. Octavian Fodor Regional Institute of Gastroenterology and Hepatology ; Gastroenterology and Hepatology Medical Center;Cluj-Napoca, Romania.
Gastroenterology and Hepatology Medical Center;Iuliu Hatieganu University of Medicine and Pharmacy;Department of Internal Medicine, 4th Medical Clinic, Cluj-Napoca, Romania.
J Gastrointestin Liver Dis. 2018 Sep;27(3):227-231. doi: 10.15403/jgld.2014.1121.273.zen.
The aim of this study is to present the experience of our center over the last 8 years in a series of patients with Zenker's diverticulum (ZD), treated using an endoscopic, minimally invasive procedure.
We retrospectively included 31 patients with a previously established diagnosis of ZD based on endoscopic and oral contrast examinations. Patients' age, comorbidities, size of the diverticulum or previous endoscopic treatment were not considered exclusion criteria. A soft, flexible diverticuloscope to expose the septum and a dual knife for "cutting" the diverticular septum were used. We analyzed the short term efficacy based on symptomatic relief and occurrence of side effects, and long term efficiency at 6 and 12 months by clinical assessment, upper gastrointestinal endoscopy and oral contrast media passage.
Patients had a mean age of 67 years (range 42-86); 55% of them were male. All patients reported symptom relief after the procedure. A decrease of more than 70% from the initial size of the diverticulum was noted. There were 3 cases (9.67%) of intraprocedural hemorrhage, endoscopically managed. No serious post-procedural complications and no mortality were reported. The mean procedural time was 21.87 minutes (range 15-25 minutes). Average hospitalization was 2.5 days. Five patients developed recurrence and needed a second session of endoscopic treatment for achieving complete myotomy.
Endoscopic management for ZD was efficient and safe in our series of patients. A short hospitalization period was required.
本研究旨在介绍我们中心在过去8年中对一系列采用内镜微创治疗的Zenker憩室（ZD）患者的治疗经验。
我们回顾性纳入了31例经内镜和口服造影检查确诊为ZD的患者。患者的年龄、合并症、憩室大小或既往内镜治疗情况均不作为排除标准。使用软质、可弯曲的憩室镜暴露隔膜，并使用双极电刀“切开”憩室隔膜。我们基于症状缓解情况和副作用发生情况分析短期疗效，并通过临床评估、上消化道内镜检查和口服造影剂通过情况分析6个月和12个月时的长期疗效。
患者的平均年龄为67岁（范围42 - 86岁）；其中55%为男性。所有患者术后均报告症状缓解。憩室初始大小缩小超过70%。术中发生3例（9.67%）出血，经内镜处理。未报告严重的术后并发症和死亡病例。平均手术时间为21.87分钟（范围15 - 25分钟）。平均住院时间为2.5天。5例患者出现复发，需要再次进行内镜治疗以实现完全肌切开术。
在我们的一系列患者中，内镜治疗ZD有效且安全。所需住院时间短。
