1. Impact of prior treatment on feasibility and outcomes of Zenker's peroral endoscopic myotomy (Z-POEM).
- Author
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Sanaei, Omid, Ichkhanian, Yervant, Mondragón, Oscar V. Hernández, Nieto, Jose, Krishnan, Arunkumar, Tantau, Marcel, Tantau, Alina, Desai, Pankaj N., Ginsberg, Gregory G., Saumoy, Monica, Deshmukh, Ameya, Attaar, Mikhail, Farha, Jad, Jovani, Manol, Al-Ghamdi, Sarah S., Ujiki, Michael, and Khashab, Mouen A.
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DIVERTICULUM , *TREATMENT effectiveness , *TECHNICAL reports , *DEGLUTITION disorders , *SYMPTOMS , *MYOTOMY , *ESOPHAGEAL diverticula , *PILOT projects , *RETROSPECTIVE studies , *IMPACT of Event Scale - Abstract
Background: Zenker's peroral endoscopic myotomy (Z-POEM) is a novel procedure for the management of symptomatic Zenker's diverticulum. This study aims to report the technical feasibility and outcomes of Z-POEM in the management of Zenker's diverticulum after prior failed interventions.Methods: Patients with persistent or recurrent symptoms after prior endoscopic and/or surgical intervention for Zenker's diverticulum were retrospectively included. The primary outcome was clinical success, defined as complete or near complete resolution of dysphagia (dysphagia score of 0 or 1) without the need for repeat endoscopic or surgical intervention during follow-up.Results: Z-POEM was technically successful in 30/32 patients (93.8 %). Clinical success was achieved in 29/30 patients (96.7 %), and Z-POEM significantly reduced the median (interquartile range [IQR]) dysphagia score of patients from 2 (1 - 2) to 0 (0) (P < 0.001) over a median duration of follow up of 166 days (IQR 39 - 566). Four patients (12.5 %) had adverse events (two inadvertent mucosotomies and two leaks found on post-procedural esophagrams).Conclusion: Z-POEM is feasible, safe, and effective in the majority of patients with recurrent symptoms after prior surgical or endoscopic interventions. [ABSTRACT FROM AUTHOR]- Published
- 2021
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