A47 ENDOSCOPIC ZENKER’S DIVERTICULOTOMY AND MYOMECTOMY:A SINGLE CENTER EXPERIENCE
Bibliographic record
Abstract
Zenker’s diverticulum is a pseudodiverticulum of the mucosa and submucosa occurring in the posterior pharyngoesophagus through Killian’s triangle. Symptoms include dysphagia, secretions, halitosis and weight loss and occur mostly in middle-aged and older adults. Historically, treatment has been extensive neck surgery and eventually rigid endoscopy. Recently, treatment by flexible endoscopic septum division (FESD) has shown excellent success rates with less morbidity1. This study aimed to evaluate the clinical response rate and complications of FESD in our single center. We conducted a single center retrospective study of endoscopic Zenker’s diverticulotomy and myomectomy by FESD performed by two different endoscopists between July 2014 and June 2017. Seven patients were included in our analysis, four of which were males. Mean age of patients was 83.7 years (range 73–92). Two patients that were taking an anticoagulant (1 Apixaban, 1 Enoxaparin) and three on Aspirin had stopped their medication the appropriate number of days prior to the procedure. Indication for procedure included severe dysphagia in 6 patients and regurgitation in 1 patient. Patients also complained of regurgitation (3 patients), secretions (2), odynophagia (1), food impaction (1), and weight loss (1). All procedures were performed with a Dual knife (Olympus). Mean diverticular size was 3.3 cm (range 2–6 cm). Mean procedural time was 23.7 min (range 10–36 min). Minimal procedural bleeding occurred in two cases and no perforation was noted. Four procedures were conducted under general anesthesia and 3 under conscious sedation. Mean follow up duration was 2 months for 6 patients (range 1–5 months), one patient was lost on follow-up. Four patients reported complete recovery of initial symptoms, and two major improvement. No patient required a second procedure or surgery. In our retrospective analysis of flexible endoscopic diverticulotomy, we showed a good response rate, with no severe complication rendering this procedure very safe and effective for symptomatic Zenker’s diverticulum. The septum of the diverticulum is exposed with the diverticuloscope and dissected with the Dual Knife None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".