[ XXXX treated by transoral diverticulostomy: technique and results].

@entity1 @entity15809 @entity1282 @entity548
AIM OF THE STUDY: The surgical technique of transoral diverticulostomy by a modified Endo-GIAtrade mark Stapler (Multifire Endo GIA, Tyco Healthcare) is described. Experiences of this procedure in 31 @entity1 are analysed and compared with different endoscopic and conventional surgical therapies of @entity15809 , which are reported in the literature. METHOD: From January 1996 to December 2005, 31 transoral diverticulostomies were performed. All @entity1 were included porspectively into the study. The median follow-up time after diverticulostomy was 54 months. Manometry, pH-study of the esophagus, endoscopy and swallow radiography were performed before and after surgery. All @entity1 completed the Gastrointestinal quality of live index (GQLI) and the Grosshadern @entity1282 score (GHDS). RESULTS: Subjective comfort of the @entity1 as measured by the Smiley Index, the GQLI and the GHDS was increased significantly (p < 0.001) after therapy. Manometry showed that the upper esophageal sphincter functioned normally before and after intervention. A gastrografin swallow excluded leakage at the stapler suture-line in all cases. A conversion to a conventional cricomyotomy with resection of the diverticulum had to be performed once due to a dissection of the esophagus that occurred during insertion of the spreader. In one @entity1 a @entity548 out of the suture line was successfully treated with a metal clip. A prothesis broke due to the insertion of the spreader. Two @entity1 developed relapses during the follow-up period of 54 months. CONCLUSION: Compared to standard procedure the endoscopic minimal-invasive therapy proved to be safer. The operation time and the postoperative stay are shorter.
