title: Flexible endoscopic treatment for Zenker's diverticulum with the SB Knife. Preliminary results from a single-center experience.
abstract: OBJECTIVE
  Flexible endoscopic septum division is becoming a prominent treatment option for Zenker's diverticulum (ZD). Over the years, various techniques have been developed and many cutting tools have been tested with varying results. We report our experience with a recently designed, monopolar, rotating, scissor-shaped device (SB Knife).
  
  
  METHODS
  Data on 31 consecutive patients that underwent flexible endoscopic treatment for ZD with the use of the SB Knife were retrieved. Dysphagia, regurgitation, and respiratory symptom severity before the procedure were graded. Procedure duration, rate of complications, symptom changes after the procedure and rate of relapsing patients during follow up were recorded.
  
  
  RESULTS
  The procedure was carried out successfully in all patients. Median procedure time was 14 min. One case of late-onset bleeding developed 1 week after the procedure, and was managed endoscopically. A significant symptom improvement was achieved (dysphagia: median score <3, median score >0, P < 0.001; regurgitation: median score <2, median score >0, P < 0.001; respiratory symptoms: median score <2, median score >0, P = 0.009). Two patients had mild relapsing symptoms, respectively, after 4 and 9 months from the procedure but refused further treatment.
  
  
  CONCLUSIONS
  Endoscopic treatment of ZD using this new device is safe and efficient at short term follow up. No perforations were observed and there was a substantial reduction of symptoms after the treatment. Larger studies are needed to fully assess advantages of this new device for endoscopic treatment of ZD.
authors.affiliation: Digestive Endoscopy Unit, Veneto Institute of Oncology IOV IRCSS, Padova.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Battaglia
authors.affiliation: Digestive Endoscopy Unit, Veneto Institute of Oncology IOV IRCSS, Padova.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Antonello
authors.affiliation: Digestive Endoscopy Unit, Veneto Institute of Oncology IOV IRCSS, Padova.
authors.forename: Stefano
authors.initials: S
authors.lastname: Realdon
authors.affiliation: Digestive Endoscopy Unit, Veneto Institute of Oncology IOV IRCSS, Padova.
authors.forename: Martina
authors.initials: M
authors.lastname: Cesarotto
authors.affiliation: Department of Surgery, Santa Maria del Prato Hospital, Feltre, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Zanatta
authors.affiliation: Department of Gastroenterology, Dudley Group Hospitals, Birmingham City University, Birmingham, UK.|Department of Medicine, St. George's University, Grenada, West Indies.
authors.forename: Sauid
authors.initials: S
authors.lastname: Ishaq
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000601:surgery*
keywords: SB knife; Zenker's diverticulum; dysphagia; endoscopic diverticulectomy; upper gastrointestinal endoscopy