An international study on the use of peroral endoscopic myotomy (POEM) in the management of esophageal diverticula: the first multicenter D-POEM experience.

Abstract

BACKGROUND:

The aim of this study is to report a novel, multicenter experience with the diverticular peroral endoscopic myotomy (D-POEM) technique in the management of esophageal diverticula.

METHODS:

This is a multicenter, international, retrospective study involving three centers. D-POEM was performed using the principles of submucosal endoscopy.

RESULTS:

A total of 11 patients with an esophageal diverticulum (Zenker's 7, mid-esophagus 1, epiphrenic 3) were included. The mean size of the esophageal diverticula was 34.5 mm. The overall technical success rate of D-POEM was 90.9 %, with a mean procedure time of 63.2 minutes. There were no adverse events. Clinical success was achieved in 100 % (10 /10), with a decrease in mean dysphagia score from 2.7 to 0.1 (P < 0.001) during a median follow-up of 145 days (interquartile range 126 - 273).

CONCLUSION:

Endoscopic management of esophageal diverticula using the novel technique of D-POEM appears promising. This first case series on D-POEM suggests that the procedure is feasible, safe, and effective in the management of esophageal diverticula. D-POEM offers the distinct advantage of ensuring a complete septotomy. Larger studies are needed to confirm these intriguing results.

• Authors: Juliana Yang, Xianhui Zeng, Xianglei Yuan, Kenneth Chang, Omid Sanaei, Lea Fayad, Vivek Kumbhari, Vikesh Singh, Anthony N Kalloo, Bing Hu, Mouen A Khashab
• Journal: Endoscopy (Endoscopy) Vol. 51 Issue 4 Pg. 346-349 (04 2019) ISSN: 1438-8812 [Electronic] Germany
• PMID: 30453378 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Topics

• Diverticulum, Esophageal (classification, diagnosis, surgery)
• Esophagoscopy (adverse effects, methods)
• Female
• Humans
• Male
• Manometry (methods)
• Middle Aged
• Myotomy (adverse effects, methods)
• Natural Orifice Endoscopic Surgery (adverse effects, methods)
• Outcome and Process Assessment, Health Care
• Retrospective Studies
• Treatment Outcome