TY - JOUR
T1 - An international study on the use of peroral endoscopic myotomy in the management of Zenker's diverticulum
AU - Yang, Juliana
AU - Novak, Stephanie
AU - Ujiki, Michael
AU - Hernández, Óscar
AU - Desai, Pankaj
AU - Benias, Petros
AU - Lee, David
AU - Chang, Kenneth
AU - Brieau, Bertrand
AU - Barret, Maximilien
AU - Kumta, Nikhil
AU - Zeng, Xianhui
AU - Hu, Bing
AU - Delis, Konstantinos
AU - Khashab, Mouen A.
N1 - Funding Information:
DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: M. Ujiki: Consultant for Olympus and Boston Scientific. K. Chang: Consultant for and/or grant recipient from Apollo, Boston Scientific, Erbe, C2 Therapeutics, Cook, Covidien, Endogastric Solutions, Mederi, Medtronic, Olympus, Ovesco, Pentax, and Torax. N. Kumta: Consultant for Apollo Endosurgery, Boston Scientific, and Olympus M.A. Khaskab: Consultant and medical advisory board for Olympus and Boston Scientific; consultant for Medtronic. All other authors disclosed no financial relationships relevant to this publication.
Publisher Copyright:
© 2020
PY - 2020/1
Y1 - 2020/1
N2 - Background and Aims: The novel use of peroral endoscopic myotomy (POEM) in the treatment of Zenker's diverticulum (ZD) was recently described in case reports. The aim of this study is to report a multicenter experience with the POEM technique in the management of ZD. Methods: This is a multicenter international retrospective study involving 10 centers. The Zenker's POEM technique was performed using principles of submucosal endoscopy. Results: Seventy-five patients (73.3 ± 1.2 years, 33 women) were included with a mean Charleson comorbidity index of 4 ±.2. The mean size of ZD was 31.3 ± 1.6 mm (range, 10-89). The overall technical success rate was 97.3% (73/75). There were 2 technical failures because of the inability to locate the septum and failed tunnel creation. Adverse events occurred in 6.7% (5/75): 1 bleed (mild) conservatively managed and 4 perforations (1 severe, 3 moderate). The mean procedure time was 52.4 ± 2.9 minutes, and mean length of hospital stay was 1.8 ±.2 days. Clinical success was achieved in 92% (69/75) with a decrease in mean dysphagia score from 1.96 to.25 (P <.0001). The median length of follow-up was 291.5 days (interquartile range, 103.5-436). At the 12-month follow-up, 1 patient reported symptom recurrence. Conclusions: Endoscopic management of ZD using the POEM technique is novel and feasible with promising efficacy and safety results. Long-term follow-up is needed to ensure durability of response. In addition, comparative studies with other treatment modalities are warranted.
AB - Background and Aims: The novel use of peroral endoscopic myotomy (POEM) in the treatment of Zenker's diverticulum (ZD) was recently described in case reports. The aim of this study is to report a multicenter experience with the POEM technique in the management of ZD. Methods: This is a multicenter international retrospective study involving 10 centers. The Zenker's POEM technique was performed using principles of submucosal endoscopy. Results: Seventy-five patients (73.3 ± 1.2 years, 33 women) were included with a mean Charleson comorbidity index of 4 ±.2. The mean size of ZD was 31.3 ± 1.6 mm (range, 10-89). The overall technical success rate was 97.3% (73/75). There were 2 technical failures because of the inability to locate the septum and failed tunnel creation. Adverse events occurred in 6.7% (5/75): 1 bleed (mild) conservatively managed and 4 perforations (1 severe, 3 moderate). The mean procedure time was 52.4 ± 2.9 minutes, and mean length of hospital stay was 1.8 ±.2 days. Clinical success was achieved in 92% (69/75) with a decrease in mean dysphagia score from 1.96 to.25 (P <.0001). The median length of follow-up was 291.5 days (interquartile range, 103.5-436). At the 12-month follow-up, 1 patient reported symptom recurrence. Conclusions: Endoscopic management of ZD using the POEM technique is novel and feasible with promising efficacy and safety results. Long-term follow-up is needed to ensure durability of response. In addition, comparative studies with other treatment modalities are warranted.
UR - http://www.scopus.com/inward/record.url?scp=85068458608&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2019.04.249
DO - 10.1016/j.gie.2019.04.249
M3 - Article
C2 - 31082393
AN - SCOPUS:85068458608
SN - 0016-5107
VL - 91
SP - 163
EP - 168
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 1
ER -