New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum:A case series

作     者：Johanna Wilmsen Robert Baumbach Dietmar Stüker Vincens Weingart Frank Neser Stefan Karl Golder Christof Pfundstein Ellen Claudia Notzel Thomas Rosch Siegbert Faiss 

作者机构：Department of Gastroenterology and Interventional EndoscopyAsklepios Hospital BarmbekSemmelweis UniversityMedical Faculty Department of Interdisciplinary EndoscopyUniversity Medical Center Tübingen Department of Internal MedicineGarmisch-Partenkirchen Medical Center Department of Internal Medicine IIHospital Chemnitz Department of Internal Medicine III Private Practice for Internal Medicine and Gastroenterology Department of Internal Medicine and GastroenterologySana Hospital Lichtenberg Department of Interdisciplinary EndoscopyUniversity Medical Center Hamburg-Eppendorf 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第17期

页      面：3084-3091页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Zenker’s diverticulum Flexible endoscopic treatment Stapler technique Overtube Surgical stapler 

摘      要：AIMTo report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible *** 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 *** 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 *** 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.