{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:26:39Z","timestamp":1790277999722,"version":"4.1.0"},"reference-count":30,"publisher":"Baishideng Publishing Group Inc.","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Gastroenterol"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Esophageal 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.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To evaluate the therapeutic effectiveness of specific treatment methods for ED with septum (ED + S) or ED without septum (ED - S) in AC patients.<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>This 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.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>The 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) vs  0 (0-2.0), P  &lt; 0.05; ED - S group: 6.0 (3.75-8.25) vs  1.0 (0-3.0), P  &lt; 0.05]. The clinical success rates (Eckardt score \u2264 3) were 88.9% and 90.0%, respectively. The GERD-Q score was used to evaluate postoperative gastroesophageal reflux, and 3 patients (3\/18, 16.7%) in ED + S group and 2 patients (2\/10, 20%) in ED - S group experienced symptomatic reflux (GERD-Q score \u2265 8).<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>In 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.<\/jats:p>","DOI":"10.3748\/wjg.v32.i9.114758","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T03:28:39Z","timestamp":1772162919000},"source":"Crossref","is-referenced-by-count":3,"title":["Simultaneous treatment of concomitant achalasia coexisting with epiphrenic diverticulum: The practice of submucosal tunneling 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