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Original article Clinical endoscopy| Volume 96, ISSUE 4, P612-619.e1, October 2022

Submucosal tunneling endoscopic septum division for esophageal diverticulum with a median follow-up of 39 months: a multicenter cohort study

Published:June 06, 2022DOI:https://doi.org/10.1016/j.gie.2022.05.021
Submucosal tunneling endoscopic septum division for esophageal diverticulum with a median follow-up of 39 months: a multicenter cohort study
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      Background and Aims

      Submucosal tunneling endoscopic septum division (STESD) is an endoscopic minimally invasive technique for treating esophageal diverticulum. The objectives of this study were to evaluate the safety and efficacy of STESD and its impact on patients’ quality of life.

      Methods

      This study included consecutive patients who underwent STESD for esophageal diverticulum from April 2016 to August 2020 in 2 centers (Zhongshan Hospital, Fudan University and Tianjin First Central Hospital). Esophagogram and endoscopic examination were performed before STESD and 30 days after STESD. Patients completed the 36-item Short Form survey (SF-36) before STESD and 1 year after surgery. Clinical symptoms were assessed via telehealth every 6 months until August 2021. Costamagna and Eckardt scores were used to evaluate changes in symptoms.

      Results

      Twenty-one patients were included. Mucosal injury 1 to 2 cm below the septum occurred in 2 patients. No severe surgical adverse events were observed. Median duration of follow-up was 39 months (range, 12-63). Total SF-36 scores increased from 118.7 ± 18.6 before STESD to 132.4 ± 9.1 at 1 year after the procedure (P = .007). SF-36 subscales of general health (P = .002), vitality (P = .004), social functioning (P = .030), and mental health (P = .020) improved significantly after STESD. The mean Costamagna score decreased from 3.83 ± 1.33 to 1.67 ± 1.51 (P = .010), whereas the mean Eckardt score decreased from 3.50 ± .90 to 1.25 ± 1.76 (P = .002). One patient developed symptom recurrence at 10 months after STESD.

      Conclusions

      STESD is a safe and valid endoscopic minimally invasive surgery for esophageal diverticulum, which can reduce symptoms and improve quality of life.

      Abbreviations:

      ED (epiphrenic diverticulum), MED (mid-esophageal diverticulum), POEM (peroral endoscopic myotomy), QOL (quality of life), SF-36 (36-item Short Form survey), STESD (submucosal tunneling endoscopic septum division), ZD (Zenker’s diverticulum)
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        • Costamagna G.
        • Iacopini F.
        • Bizzotto A.
        • et al.
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        Gastrointest Endosc. 2016; 83: 765-773
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        Treatment and surveillance strategies in achalasia: an update.
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      Article info

      Publication history

      Published online: June 06, 2022
      Accepted: May 28, 2022
      Received: January 2, 2022

      Footnotes

      DISCLOSURE: All authors disclosed no financial relationships. Research support for this study was provided by grants from the National Key R&D Program of China (2019YFC1315800, P.-H. Zhou), National Natural Science Foundation of China (82170555, Q.-L. Li), Shanghai Rising-Star Program (19QA1401900, Q.-L. Li), and Major Project of Shanghai Municipal Science and Technology Committee (19441905200, W.-F. Chen).

      If you would like to chat with an author of this article, you may contact Dr Li at [email protected] or Dr Zhou at [email protected]

      Identification

      DOI: https://doi.org/10.1016/j.gie.2022.05.021

      Copyright

      © 2022 by the American Society for Gastrointestinal Endoscopy

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