TOPLINE:

Submucosal tunneling endoscopic septum division (STESD), a minimally invasive treatment, is safe and effective for esophageal diverticulum, producing significant symptom relief with minimal complications.

METHODOLOGY:

• Esophageal diverticula are uncommon but can cause significant symptoms and complications as they enlarge. Traditional surgical approaches (eg, myotomy and diverticulectomy) carry risks for perforation, wound infection, and mediastinitis.
• Investigators conducted a retrospective study to evaluate the safety and efficacy of STESD as a minimally invasive treatment option for esophageal diverticulum.
• Follow-up endoscopy and esophagography were performed 30 days after STESD. Symptoms were assessed via telehealth at 6 months using standardized scores (Costamagna for Zenker’s diverticulum; Eckardt for mid-esophageal and epiphrenic diverticula).
• The primary outcome was the improvement in symptom scores post-STESD. Secondary outcomes included adverse events, change in diverticulum size, procedure duration, and length of hospital stay.

TAKEAWAY:

• The cohort included 62 patients (mean age, 58.7 years; 54.8% women): 23 with Zenker’s diverticulum, 13 with mid-esophageal diverticulum, and 26 with epiphrenic diverticulum. The mean diverticulum depth before STESD was 24.3 mm.
• Symptom scores improved significantly on both the Costamagna and Eckardt scales after STESD (P < .001 for both), indicating substantial alleviation.
• The mean procedure duration was 36.2 minutes, and the average length of hospital stay was 4.0 days.
• Procedure-related adverse events were minimal, with one mucosal injury and one perforation, both successfully managed with conservative treatment.
• Symptom recurrence occurred in one patient and resolved after repeat STESD.

IN PRACTICE:

“STESD is a novel, safe, and valid method of minimally invasive procedure for the endoscopic treatment of esophageal diverticulum. It can improve symptoms in patients with an esophageal diverticulum,” the authors of the study wrote.

SOURCE:

This study was led by Zi-Han Geng, Zhongshan Hospital, Fudan University, Shanghai, China. It was published online in the Journal of Gastroenterology and Hepatology.

LIMITATIONS:

The study had a small sample size and potential bias due to its retrospective design.

DISCLOSURES:

The study reported receiving support from the National Natural Science Foundation of China, Shanghai Academic/Technology Research Leader, and other sources. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.