Endoscopy 2020; 52(S 01): S100
DOI: 10.1055/s-0040-1704305
ESGE Days 2020 oral presentations
Friday, April 24, 2020 14:30 – 16:30 Exploring the underworld: Upper GIsubmucosal therapy Wicklow Meeting Room 1
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC MYOTOMY IN ZENKER´S DIVERTICULUM - EFFICIENCY, COMPLICATIONS AND RECCURRENCE RATE

F Straulino
1   Klinikum Hanau, Medizinische Klinik II, Hanau, Germany
,
A Genthner
1   Klinikum Hanau, Medizinische Klinik II, Hanau, Germany
,
S Kangalli
1   Klinikum Hanau, Medizinische Klinik II, Hanau, Germany
,
I Reiffenstein
1   Klinikum Hanau, Medizinische Klinik II, Hanau, Germany
,
A Eickhoff
1   Klinikum Hanau, Medizinische Klinik II, Hanau, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims These days endoscopic myotomy in patients with Zenker’s diverticulum is an established therapy. No need for general anaesthesia and less invasivness are advantages of the endoscopic therapy, but the high recurrence rate compared to the surgical therapeutic options are a problem. In this retrospective study we report the efficiency and complications in patients treated endoscopic for Zenker’s diverticulum a tour hospital since 2010.

    Methods From a database we retrospectively analysed the technical implemantation of the procedure and complications afterwards. A telephone survey was carried out to assess symptoms pointing to recurrence of the diseases.

    Results From 01/2011 to 09/2019 85 patients with an average age of 72,14 (59-95) years were treated with endoscopic myotomy for Zenker’s diverticulum. In 7 patients transoral stapling was not possible and in one patient an endoscopic attempt was unsuccessful in the past. The diverticulotomy was carried out with the needle knife (n=80), APC (n=3) or SB-knife (n=2). In 81 patients (95%) the diverticulotomy was completed in one sessions, in 4 patients a second procedure was necessary. There was one perforation which was treated with fasting and antibiotics. In two patients there was a collar emphysema without clinical relevance. The follow-up was 34,4

    (3-106) month with clinical response in all patients. In 15 patients (17,76%) there was a reccurence with in median 12,56 (2-48) month after initially treatment. In all patients treated with APC there was a recurrence of the disease. Furthermore the recurrence rate was higher in the first half of the observation period (5/20 versus 5/40) An endoscopic treatment of the recurrent diverticulum was possible without complications.

    Conclusions The endoscopic myotomy is an effective and save procedure in patientes with Zenker’s diverticulum. The high recurrence rate is the main disadvantage, but it probably can be reduced with a resolute complete myotomy of all muscle fibres.


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