Liu Ruide, Zeng Xianhui, Yuan Xianglei, Liu Wei, Liu Shuang, Zhu Yinong, Hu Bing
Department of Gastroenterology and Hepatology, West China Hospital, Medical Engineering Integration Laboratory of Digestive Endoscopy, West China Hospital, Sichuan University, No.37, Guo Xue Alley, Wuhou district, Chengdu, Sichuan Province, China.
Department of Gastroenterology and Hepatology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
BMC Gastroenterol. 2025 Mar 21;25(1):193. doi: 10.1186/s12876-025-03783-5.
The development of the magnetic compression technique (MCT) for the gastrointestinal (GI) tract has been widely applied in the treatment of biliary strictures, esophageal atresia, and GI anastomoses. Our team combined the MCT and minimally invasive endoscopic operation to propose a novel alternative procedure called magnet-assisted diverticuloplasty (MAD) for treating various esophageal diverticula. This case series aimed to report the effectiveness, safety, and our experience of MAD.
This retrospective case series included patients with symptomatic esophageal diverticulum (SED) who underwent MAD between November 2017 and June 2022 in West China Hospital, Sichuan University. The patients' symptomatic scores were accessed by Eckardt symptomatic scores. The telephone follow-up period ended in March 2023. The primary outcome of the study was clinical success. Secondary outcomes included the technical success of MAD, procedure time, hospitalization, recurrence, and adverse events.
We reported 6 patients with SED who underwent MAD (3 with Zenker's, 1 with middle, and 2 with lower esophageal diverticulum). The technical success rate was 100% (6/6) and no adverse events were reported. The median procedural duration was 22.5 min (interquartile range (IQR) 18.5). The mean hospitalization was 2 days (range 1-3). The median time of follow-up endoscopy was on postoperative day 18 (IQR 31), revealing a shortened diverticular septum under endoscopic examination. After a median telephone follow-up of 23 months (IQR 36), the median total symptomatic score decreased significantly from 4.00 (IQR 3.25) to 1.00 (IQR 2.00) (P = 0.015). The clinical success rate was 83.3% (5/6), and only one patient had recurrent symptoms two years after MAD.
MAD provided a novel method for treating SED. Our limited experience suggested that MAD could be minimally invasive and effective. More extensive, multicenter prospective studies were needed to assess this technique further.
胃肠道磁压缩技术（MCT）的发展已广泛应用于胆管狭窄、食管闭锁和胃肠道吻合术的治疗。我们的团队将MCT与微创内镜手术相结合，提出了一种名为磁辅助憩室成形术（MAD）的新型替代手术，用于治疗各种食管憩室。本病例系列旨在报告MAD的有效性、安全性及我们的经验。
本回顾性病例系列纳入了2017年11月至2022年6月在四川大学华西医院接受MAD治疗的有症状食管憩室（SED）患者。通过埃卡特症状评分评估患者的症状评分。电话随访期至2023年3月结束。该研究的主要结局是临床成功。次要结局包括MAD的技术成功、手术时间、住院时间、复发情况及不良事件。
我们报告了6例接受MAD治疗的SED患者（3例Zenker憩室、1例中段食管憩室和2例下段食管憩室）。技术成功率为100%（6/6），且未报告不良事件。手术持续时间中位数为22.5分钟（四分位间距[IQR]18.5）。平均住院时间为2天（范围1 - 3天）。随访内镜检查的中位时间为术后第18天（IQR 31），在内镜检查下显示憩室隔膜缩短。经过中位23个月（IQR 36）的电话随访，总症状评分中位数从4.00（IQR 3.25）显著降至1.00（IQR 2.00）（P = 0.015）。临床成功率为83.3%（5/6），只有1例患者在MAD术后两年出现复发症状。
MAD为治疗SED提供了一种新方法。我们有限的经验表明，MAD可能具有微创性且有效。需要更广泛的多中心前瞻性研究来进一步评估该技术。
