Zenker's peroral endoscopic myotomy for management of large Zenker's diverticulum.
Journal
Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
medline:
29
5
2023
pubmed:
25
2
2023
entrez:
24
2
2023
Statut:
ppublish
Résumé
Zenker's diverticulum peroral endoscopic myotomy (zPOEM) is a minimally invasive treatment strategy for Zenker's diverticulum, with excellent results for management of small-to-moderate Zenker's diverticulum. We evaluated its use in the management of large Zenker's diverticulum. This was a retrospective multicenter cohort study across 11 international centers including adult patients with large Zenker's diverticulum ≥ 40 mm treated by zPOEM between March 2017 and March 2022. The primary outcome was clinical success (dysphagia score ≤ 1 without need for further intervention). Secondary outcomes included technical success (complete myotomy as intended), adverse events (AEs), and rate of recurrence. 83 patients (male 62.7 %, mean age 72.6 [SD 11.5] years) underwent zPOEM for treatment of large Zenker's diverticulum (median size 50 mm, interquartile range [IQR] 41-55 mm, range 40-80 mm). The zPOEM procedure was technically successful in 82 patients (98.8 %), with a mean procedure time of 48.7 (SD 23.2) minutes. Clinical success was achieved in 71 patients (85.5 %). Median (IQR) symptom scores improved significantly from baseline for dysphagia (2 2 3 vs. 0 [0-2]; This study demonstrated safe and effective use of zPOEM in the management of large Zenker's diverticulum.
Sections du résumé
BACKGROUND
Zenker's diverticulum peroral endoscopic myotomy (zPOEM) is a minimally invasive treatment strategy for Zenker's diverticulum, with excellent results for management of small-to-moderate Zenker's diverticulum. We evaluated its use in the management of large Zenker's diverticulum.
METHODS
This was a retrospective multicenter cohort study across 11 international centers including adult patients with large Zenker's diverticulum ≥ 40 mm treated by zPOEM between March 2017 and March 2022. The primary outcome was clinical success (dysphagia score ≤ 1 without need for further intervention). Secondary outcomes included technical success (complete myotomy as intended), adverse events (AEs), and rate of recurrence.
RESULTS
83 patients (male 62.7 %, mean age 72.6 [SD 11.5] years) underwent zPOEM for treatment of large Zenker's diverticulum (median size 50 mm, interquartile range [IQR] 41-55 mm, range 40-80 mm). The zPOEM procedure was technically successful in 82 patients (98.8 %), with a mean procedure time of 48.7 (SD 23.2) minutes. Clinical success was achieved in 71 patients (85.5 %). Median (IQR) symptom scores improved significantly from baseline for dysphagia (2 2 3 vs. 0 [0-2];
CONCLUSION
This study demonstrated safe and effective use of zPOEM in the management of large Zenker's diverticulum.
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
501-507Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
J. Nieto is a consultant for Boston Scientific, Olympus, and ConMed. M. Ujiki is a board member for Boston Scientific, a consultant for Olympus and Cook, and has received grant funding from Medtronic and payments for lectures from Medtronic, Erbe, and Gore. R.E. Kim is a consultant for Medtronic and Cook Medical. N.A. Kumta is a consultant for Apollo Endosurgery, Boston Scientific, Olympus, Intuitive Surgical, and SafeHeal. M.A. Khashab is a consultant for Boston Scientific, Olympus America, Medtronic, Apollo Endosurgery, Pentax, and GI Supply; he also receives royalties from UpToDate and Elsevier. L.Y. Zhang, O. Hernandez Mondragon, M. Pioche, S.N. Steinway, V.N. VanDruff, A. Canakis, M. Tantau, A. Tantau, A. Pop, J. Jacques, M. Lajin, P. Desai, A. Shrigiriwar, and M. Bejjani declare that they have no conflict of interest.