Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Gastroenterology, Tianjin First Central Hospital, Tianjin, China.
Gastrointest Endosc. 2022 Oct;96(4):612-619.e1. doi: 10.1016/j.gie.2022.05.021. Epub 2022 Jun 6.
Submucosal tunneling endoscopic septum division (STESD) is an endoscopic minimally invasive technique for treating esophageal diverticulum. The objectives of this study were to evaluate the safety and efficacy of STESD and its impact on patients' quality of life.
This study included consecutive patients who underwent STESD for esophageal diverticulum from April 2016 to August 2020 in 2 centers (Zhongshan Hospital, Fudan University and Tianjin First Central Hospital). Esophagogram and endoscopic examination were performed before STESD and 30 days after STESD. Patients completed the 36-item Short Form survey (SF-36) before STESD and 1 year after surgery. Clinical symptoms were assessed via telehealth every 6 months until August 2021. Costamagna and Eckardt scores were used to evaluate changes in symptoms.
Twenty-one patients were included. Mucosal injury 1 to 2 cm below the septum occurred in 2 patients. No severe surgical adverse events were observed. Median duration of follow-up was 39 months (range, 12-63). Total SF-36 scores increased from 118.7 ± 18.6 before STESD to 132.4 ± 9.1 at 1 year after the procedure (P = .007). SF-36 subscales of general health (P = .002), vitality (P = .004), social functioning (P = .030), and mental health (P = .020) improved significantly after STESD. The mean Costamagna score decreased from 3.83 ± 1.33 to 1.67 ± 1.51 (P = .010), whereas the mean Eckardt score decreased from 3.50 ± .90 to 1.25 ± 1.76 (P = .002). One patient developed symptom recurrence at 10 months after STESD.
STESD is a safe and valid endoscopic minimally invasive surgery for esophageal diverticulum, which can reduce symptoms and improve quality of life.
黏膜下隧道内镜隔切开术（STESD）是一种治疗食管憩室的内镜微创技术。本研究的目的是评估 STESD 的安全性和有效性，及其对患者生活质量的影响。
本研究纳入了 2016 年 4 月至 2020 年 8 月在 2 家中心（复旦大学中山医院和天津第一中心医院）接受 STESD 治疗的食管憩室连续患者。在 STESD 前和 STESD 后 30 天进行食管造影和内镜检查。患者在 STESD 前和手术后 1 年完成 36 项简明健康调查问卷（SF-36）。通过远程医疗每 6 个月评估一次临床症状，直到 2021 年 8 月。Costamagna 和 Eckardt 评分用于评估症状变化。
共纳入 21 例患者。2 例患者出现距隔下 1-2cm 处的黏膜损伤。未观察到严重的手术不良事件。中位随访时间为 39 个月（范围 12-63）。总 SF-36 评分从 STESD 前的 118.7±18.6 分增加到术后 1 年的 132.4±9.1 分（P=.007）。SF-36 一般健康状况（P=.002）、活力（P=.004）、社会功能（P=.030）和心理健康（P=.020）等亚量表在 STESD 后显著改善。Costamagna 评分从 3.83±1.33 降至 1.67±1.51（P=.010），Eckardt 评分从 3.50±0.90 降至 1.25±1.76（P=.002）。1 例患者在 STESD 后 10 个月出现症状复发。
STESD 是一种治疗食管憩室的安全有效的内镜微创手术，可减轻症状，提高生活质量。
