P92 TRACTION OF THE SEPTUM DURING TRANSORAL SEPTOTOMY IN PATIENT WITH ZENKER DIVERTICULUM. (23rd November 2019) - Provenzano, L
Abstract: Background: Transoral Diverticulostomy/Septotomy has become a popular treatment for patients with Zenker Diverticulum (ZD) because of lower complication rates, reduced procedure time, and shorter hospital stay. However, the outcome of this procedure is not, so far, as positive as the open techniques: in literature a positive final results is reported around 75-90%. Methods: Since 2015, we adopted a modified technique (MTS), by positioning 2 sutures at the lateral edges of the septum, for traction. Symptoms were collected and scored using a detailed questionnaire; barium-swallow (to assess the size of the pouch), endoscopy and manometry were performed before and after surgical treatment. Failures were defined when a patient needed an additional procedure for recurrent symptoms. The video shows this modified trans-oral technique and we present the preliminary results of this approach. Results: 58 patients representing the study population (M:F=37:21), the median age was 74 (35-90). Six patients had a history of previous treatments for ZD. Only two intraoperative mucosal lesions were detected and mortality was nil. The median time of the procedure was 30 min (IQR:25-36) in the MTS. All the patients had a reduction in the symptom score after the procedure and the failure rate was 1.7% (1/58). Conclusions: Traction of the septum with two stitches during Transoral Septotomy improves the final outcome of this treatment in patients with ZD.