New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series
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New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series. / Wilmsen, Johanna; Baumbach, Robert; Stüker, Dietmar; Weingart, Vincens; Neser, Frank; Gölder, Stefan Karl; Pfundstein, Christof; Nötzel, Ellen Claudia; Rösch, Thomas; Faiss, Siegbert.
in: WORLD J GASTROENTERO, Jahrgang 23, Nr. 17, 07.05.2017, S. 3084-3091.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series
AU - Wilmsen, Johanna
AU - Baumbach, Robert
AU - Stüker, Dietmar
AU - Weingart, Vincens
AU - Neser, Frank
AU - Gölder, Stefan Karl
AU - Pfundstein, Christof
AU - Nötzel, Ellen Claudia
AU - Rösch, Thomas
AU - Faiss, Siegbert
PY - 2017/5/7
Y1 - 2017/5/7
N2 - AIM: To report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible endoscopy.METHODS: From November 2014 till December 2015 17 patients (8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum (mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler (MicroCutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum. The septum was divided by the staple rows under flexible endoscopic control.RESULTS: In eleven patients (64.7%) the stapler successfully divided the septum completely. Mean procedure time was 21 min, medium size of the septum was 2.8 cm (range 1.5 cm to 4 cm). In four patients the septum was shorter than 3 cm, in seven longer than 3 cm. To divide the septum, averagely 1.3 stapler cartridges were used. Two minor bleedings occurred. Major adverse events like perforation or secondary haemorrhage did not occur. After an average time of two days patients were discharged from the hospital. In 6 patients (35.3%) the stapler failed due to a thick septum or insufficient reclination of the head. Follow up endoscopy was performed after an average of two months in 9 patients; 4 patients (44.4%) were free of symptoms, 5 patients (55.6%) stated an improvement. A relapse of symptoms did not occur.CONCLUSION: Flexible endoscopic Zenker diverticulotomy by using a surgical stapler is a new, safe and efficient treatment modality. A simultaneously tissue opening and occlusion prevents major complications.
AB - AIM: To report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible endoscopy.METHODS: From November 2014 till December 2015 17 patients (8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum (mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler (MicroCutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum. The septum was divided by the staple rows under flexible endoscopic control.RESULTS: In eleven patients (64.7%) the stapler successfully divided the septum completely. Mean procedure time was 21 min, medium size of the septum was 2.8 cm (range 1.5 cm to 4 cm). In four patients the septum was shorter than 3 cm, in seven longer than 3 cm. To divide the septum, averagely 1.3 stapler cartridges were used. Two minor bleedings occurred. Major adverse events like perforation or secondary haemorrhage did not occur. After an average time of two days patients were discharged from the hospital. In 6 patients (35.3%) the stapler failed due to a thick septum or insufficient reclination of the head. Follow up endoscopy was performed after an average of two months in 9 patients; 4 patients (44.4%) were free of symptoms, 5 patients (55.6%) stated an improvement. A relapse of symptoms did not occur.CONCLUSION: Flexible endoscopic Zenker diverticulotomy by using a surgical stapler is a new, safe and efficient treatment modality. A simultaneously tissue opening and occlusion prevents major complications.
KW - Journal Article
U2 - 10.3748/wjg.v23.i17.3084
DO - 10.3748/wjg.v23.i17.3084
M3 - SCORING: Journal article
C2 - 28533665
VL - 23
SP - 3084
EP - 3091
JO - WORLD J GASTROENTERO
JF - WORLD J GASTROENTERO
SN - 1007-9327
IS - 17
ER -