ArticleWorld journal of gastroenterology2026
Simultaneous treatment of concomitant achalasia coexisting with epiphrenic diverticulum: The practice of submucosal tunneling technique.
Article in World journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Recent advances in managing esophageal epiphrenic diverticula: a review of the impact of endoscopy, high-resolution manometry, and POEM.Clinical journal of gastroenterology · 2026Review
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9 authors.
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Abstract
backgroundEsophageal epiphrenic diverticulum (ED) often occurs in patients with esophageal motility disorders, and its incidence rate is approximately 3%-7% in achalasia (AC). A distinct septum has been observed in some patients with AC coexisting with ED during gastroscopy. Digestive endoscopic tunnel technique has emerged as a promising therapeutic approach for these patients.
aimTo evaluate the therapeutic effectiveness of specific treatment methods for ED with septum (ED + S) or ED without septum (ED - S) in AC patients.
methodsThis retrospective cohort study included 31 patients with AC and esophageal diverticula (21 patients with septum and 10 patients without septum) between January 2016 and January 2025. In ED + S group, submucosal tunneling myotomy combined with diverticular septotomy was performed, while patients in the ED - S group underwent submucosal myotomy alone. The Eckardt scores before and after surgery were compared to evaluate symptom relief and clinical success. The Gastroesophageal Reflux Disease Questionnaire (GERD-Q) score and gastroscopy findings were used to evaluate postoperative gastroesophageal reflux.
resultsThe corresponding operation steps were completed in both groups, with a technical success rate of 100%. We successfully followed up with 18 and 10 patients in the ED + S and ED - S group, with a median follow-up period of 2.5 years and 3.0 years, respectively. The postoperative Eckardt scores [median (interquartile range)] were significantly lower in both groups compared with preoperative scores [ED + S group: 6.0 (4.0-8.0)
conclusionIn AC patients with ED + S, submucosal tunneling myotomy with diverticular septotomy can achieve good therapeutic effects. When there is no obvious septum, submucosal tunneling myotomy is an effective method.
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