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New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series
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 i...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423045/ https://www.ncbi.nlm.nih.gov/pubmed/28533665 http://dx.doi.org/10.3748/wjg.v23.i17.3084 |
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author | Wilmsen, Johanna Baumbach, Robert Stüker, Dietmar Weingart, Vincens Neser, Frank Gölder, Stefan Karl Pfundstein, Christof Nötzel, Ellen Claudia Rösch, Thomas Faiss, Siegbert |
author_facet | Wilmsen, Johanna Baumbach, Robert Stüker, Dietmar Weingart, Vincens Neser, Frank Gölder, Stefan Karl Pfundstein, Christof Nötzel, Ellen Claudia Rösch, Thomas Faiss, Siegbert |
author_sort | Wilmsen, Johanna |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5423045 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-54230452017-05-22 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 World J Gastroenterol Retrospective Study 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. Baishideng Publishing Group Inc 2017-05-07 2017-05-07 /pmc/articles/PMC5423045/ /pubmed/28533665 http://dx.doi.org/10.3748/wjg.v23.i17.3084 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Retrospective Study Wilmsen, Johanna Baumbach, Robert Stüker, Dietmar Weingart, Vincens Neser, Frank Gölder, Stefan Karl Pfundstein, Christof Nötzel, Ellen Claudia Rösch, Thomas Faiss, Siegbert New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series |
title | New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series |
title_full | New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series |
title_fullStr | New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series |
title_full_unstemmed | New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series |
title_short | New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum: A case series |
title_sort | new flexible endoscopic controlled stapler technique for the treatment of zenker's diverticulum: a case series |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423045/ https://www.ncbi.nlm.nih.gov/pubmed/28533665 http://dx.doi.org/10.3748/wjg.v23.i17.3084 |
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