Zenker's peroral endoscopic myotomy for management of large Zenker's diverticulum.
Endoscopy
; 55(6): 501-507, 2023 06.
Article
en En
| MEDLINE
| ID: mdl-36827992
ABSTRACT
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 ≥â40âmm treated by zPOEM between March 2017 and March 2022.âThe primary outcome was clinical success (dysphagia score ≤â1 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 62.7â%, mean age 72.6 [SD 11.5] years) underwent zPOEM for treatment of large Zenker's diverticulum (median size 50âmm, interquartile range [IQR] 41-55âmm, range 40-80âmm). The zPOEM procedure was technically successful in 82 patients (98.8â%), with a mean procedure time of 48.7 (SD 23.2) minutes. Clinical success was achieved in 71 patients (85.5â%). Median (IQR) symptom scores improved significantly from baseline for dysphagia (2 2 3 vs. 0 [0-2]; Pâ<â0.001), regurgitation (3 2 3 4 vs. 0 [0-0]; Pâ<â0.001), and respiratory symptoms (2 [0-3] vs. 0 [0-0]; Pâ<â0.001). Among patients achieving clinical success, only one recurrence (1.4â%) was recorded during a median follow-up of 12.2 months (IQR 3-28). Post-procedure AEs, all mild to moderate, occurred in four patients (4.8â%).CONCLUSION:
This study demonstrated safe and effective use of zPOEM in the management of large Zenker's diverticulum.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Trastornos de Deglución
/
Divertículo de Zenker
/
Miotomía
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Humans
/
Male
Idioma:
En
Año:
2023
Tipo del documento:
Article