Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated Patients

Background and Aims. Flexible endoscopic treatment plays an important role in the treatment of Zenker’s diverticulum (ZD). This study analyzes long-term symptom control and the rate of adverse events in treatment-naïve patients and patients with recurrence, using the stag beetle knife junior (sb kni...

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Main Authors: Johannes Manzeneder, Christoph Römmele, Carolin Manzeneder, Alanna Ebigbo, Helmut Messmann, Stefan Karl Goelder
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2021/9237617
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author Johannes Manzeneder
Christoph Römmele
Carolin Manzeneder
Alanna Ebigbo
Helmut Messmann
Stefan Karl Goelder
author_facet Johannes Manzeneder
Christoph Römmele
Carolin Manzeneder
Alanna Ebigbo
Helmut Messmann
Stefan Karl Goelder
author_sort Johannes Manzeneder
collection DOAJ
description Background and Aims. Flexible endoscopic treatment plays an important role in the treatment of Zenker’s diverticulum (ZD). This study analyzes long-term symptom control and the rate of adverse events in treatment-naïve patients and patients with recurrence, using the stag beetle knife junior (sb knife jr). Methods. From August 2013 to May 2019, 100 patients with symptomatic ZD were treated with flexible endoscopy using the sb knife jr. Before treatment, as well as 1 and 6 months afterwards, symptoms were obtained by a nine-point questionnaire, with symptoms weighted from 0 to 4. Results. Overall, 126 interventions were performed. The median follow-up period was 41 months (range 7-74). For the three most frequent symptoms, regurgitation, dysphagia, and dry cough, a significant reduction of the mean score could be achieved, from 2.85/3.45/2.85 before the initial treatment to 0.56/1.09/0.98 6 months later. 17 patients were retreated because of recurrence. Out of these, 12 patients underwent a 2nd, 4 patients a 3rd, and 1 patient a 4th session, respectively. The mean dysphagia score for successfully treated patients could be reduced from initially 2.34 to 0.49/0.33/0.67 after the 1st/2nd/3rd session, the frequency of dysphagia from 3.45 to 0.92/1.00/1.33, and the score for regurgitations from 2.85 to 0.35/1.00/0.67. In first-line treatment, as well as in retreatment, no severe adverse event occurred. Conclusion. Patients with ZD can be treated safely and effectively with the sb knife jr. Retreatment leads to equal symptom relief as compared to a successful first-line treatment and is not associated with a higher rate of adverse events.
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spelling doaj-art-b3b93abd4a7d4308b9937e228baad1c82025-08-20T03:20:54ZengWileyGastroenterology Research and Practice1687-61211687-630X2021-01-01202110.1155/2021/92376179237617Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated PatientsJohannes Manzeneder0Christoph Römmele1Carolin Manzeneder2Alanna Ebigbo3Helmut Messmann4Stefan Karl Goelder5Department of Internal Medicine III at the University Hospital Augsburg, GermanyDepartment of Internal Medicine III at the University Hospital Augsburg, GermanyDepartment of Internal Medicine III at the University Hospital Augsburg, GermanyDepartment of Internal Medicine III at the University Hospital Augsburg, GermanyDepartment of Internal Medicine III at the University Hospital Augsburg, GermanyDepartment of Internal Medicine III at the University Hospital Augsburg, GermanyBackground and Aims. Flexible endoscopic treatment plays an important role in the treatment of Zenker’s diverticulum (ZD). This study analyzes long-term symptom control and the rate of adverse events in treatment-naïve patients and patients with recurrence, using the stag beetle knife junior (sb knife jr). Methods. From August 2013 to May 2019, 100 patients with symptomatic ZD were treated with flexible endoscopy using the sb knife jr. Before treatment, as well as 1 and 6 months afterwards, symptoms were obtained by a nine-point questionnaire, with symptoms weighted from 0 to 4. Results. Overall, 126 interventions were performed. The median follow-up period was 41 months (range 7-74). For the three most frequent symptoms, regurgitation, dysphagia, and dry cough, a significant reduction of the mean score could be achieved, from 2.85/3.45/2.85 before the initial treatment to 0.56/1.09/0.98 6 months later. 17 patients were retreated because of recurrence. Out of these, 12 patients underwent a 2nd, 4 patients a 3rd, and 1 patient a 4th session, respectively. The mean dysphagia score for successfully treated patients could be reduced from initially 2.34 to 0.49/0.33/0.67 after the 1st/2nd/3rd session, the frequency of dysphagia from 3.45 to 0.92/1.00/1.33, and the score for regurgitations from 2.85 to 0.35/1.00/0.67. In first-line treatment, as well as in retreatment, no severe adverse event occurred. Conclusion. Patients with ZD can be treated safely and effectively with the sb knife jr. Retreatment leads to equal symptom relief as compared to a successful first-line treatment and is not associated with a higher rate of adverse events.http://dx.doi.org/10.1155/2021/9237617
spellingShingle Johannes Manzeneder
Christoph Römmele
Carolin Manzeneder
Alanna Ebigbo
Helmut Messmann
Stefan Karl Goelder
Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated Patients
Gastroenterology Research and Practice
title Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated Patients
title_full Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated Patients
title_fullStr Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated Patients
title_full_unstemmed Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated Patients
title_short Endoscopic Treatment of Zenker’s Diverticulum: Comparable Treatment Outcomes in Treatment-Naïve and Pretreated Patients
title_sort endoscopic treatment of zenker s diverticulum comparable treatment outcomes in treatment naive and pretreated patients
url http://dx.doi.org/10.1155/2021/9237617
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