Short-term clinical and technical outcomes of a modified Zenker’s peroral endoscopic myotomy with mucosal flap incision
Zenker's diverticulum peroral endoscopic myotomy (Z-POEM) is an effective treatment for symptomatic Zenker's diverticulum. A modification to Z-POEM involves mucosal flap incision (MFI). We describe the technical and clinical success of patients who underwent Z-POEM with MFI.We included patients who underwent Z-POEM with MFI for Zenker's diverticulum at eight international centers. The primary outcome was the rate of clinical success, assessed by post-procedure Kothari-Haber symptom score (KHSS) without re-treatment. Secondary outcomes included technical success, serious adverse events, and clinical recurrence with need for re-treatment.36 patients (age 69 [SD 9] years; 69% male) underwent Z-POEM with MFI for symptomatic Zenker's diverticulum. Mean diverticulum size was 3.2 (SD 1.4) cm. Clinical success was achieved in 35 patients (97%). Median baseline KHSS was 6 and median post-procedure KHSS was 0 (P < 0.001). Technical success was achieved in all cases. Mean procedure time was 57 (SD 34) minutes and median follow-up time was 196 days (interquartile range 39-499). There was one adverse event (3%), which was treated endoscopically.Z-POEM with MFI had high rates of technical and clinical success. Prospective evaluation is needed to further validate this technique in patients with a large Zenker's diverticulum.
Authors
- Prashant Kedia (ORCID: https://orcid.org/0000-0001-6472-0902)
- Farimah Fayyaz (ORCID: https://orcid.org/0000-0002-5692-0370)
- Shaimaa Elkholy (ORCID: https://orcid.org/0000-0003-4322-6467)
- Amit Mehta (ORCID: https://orcid.org/0000-0001-5721-9589)
- Miguel Puga‐Tejada (ORCID: https://orcid.org/0000-0001-8853-0847)
- Martha Arevalo-Mora
- Jorge Baquerizo‐Burgos (ORCID: https://orcid.org/0000-0002-6741-4211)
- Apurva Shrigiriwar (ORCID: https://orcid.org/0000-0003-1590-8997)
- Michael Lajin (ORCID: https://orcid.org/0000-0001-7376-3461)
- Karim Essam
- María Egas-Izquierdo (ORCID: https://orcid.org/0000-0002-3031-0654)
- Jose Antonio Almario (ORCID: https://orcid.org/0000-0002-6804-0645)
- Raymond Eunho Kim
- Andrew Canakis (ORCID: https://orcid.org/0000-0002-6646-6693)
- Carlos Robles‐Medranda (ORCID: https://orcid.org/0000-0003-2434-3369)
- Raquel Del Valle (ORCID: https://orcid.org/0000-0001-7891-2913)
- Michał F. Kamiński (ORCID: https://orcid.org/0000-0002-9714-6457)
- Dennis J. Yang (ORCID: https://orcid.org/0000-0003-3038-4669)
- Domenica Cunto
- Aleksandra Borkowicz
- Hany Haggag
- Mohamed El-Sherbiny (ORCID: https://orcid.org/0000-0001-5940-7700)
- Juan Alcivar Vasquez
- Mouen A. Khashab
- Kerolis Yousef
- Abeer Abdallatef
Institutions
- University of Maryland, Baltimore (US)
- Johns Hopkins University (US)
- Cairo University (EG)
- Altran (France) (FR)
- AdventHealth Orlando (US)
- Johns Hopkins Medicine (US)
- Sharp Grossmont Hospital (US)
- National Institute of Oncology (HU)
- Sharp HealthCare Foundation (US)
- Methodist Hospital (US)
- Postgraduate School of Molecular Medicine (PL)
- Johns Hopkins Hospital (US)
- The Maria Sklodowska-Curie National Research Institute of Oncology (PL)
- Instituto Ecuatoriano de Enfermedades Digestivas (EC)
- Methodist Dallas Medical Center (US)
- Kennedy Clinic Hospital (EC)
Publication Details
- Journal
- Endoscopy
- Published
- 2024-10-24
- DOI
- https://doi.org/10.1055/a-2451-2869
- Citations
- 7
- Primary Topic
- Dysphagia Assessment and Management
- Type
- article
- Field-Weighted Citation Impact
- 6.11