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5. TECHNICAL AND CLINICAL OUTCOMES OF A MODIFIED ZENKER'S PERORAL ENDOSCOPIC MYOTOMY (Z-POEM) TECHNIQUE WITH MUCOSAL FLAP INCISION (MFI)

Author

Almario, Jose Antonio, Shrigiriwar, Apurva, Mehta, Amit, El-Sherbiny, Mohamed, Essam, Karim, Haggag, Hany, Yousef, Kerolis, Abdellatef, Abeer, Elkholy, Shaimaa, Canakis, Andrew, Kim, Raymond, Yang, Dennis, Puga-Tejada, Miguel, Alcívar-Vásquez, Juan, Egas-Izquierdo, Maria, Del Valle, Raquel, Cunto, Domenica, Baquerizo-Burgos, Jorge, Arevalo-Mora, Martha, Robles-Medranda, Carlos, Borkowicz, Aleksandra, Kaminski, Michal, Lajin, Michael, Kedia, Prashant, and Khashab, Mouen

Published
2023
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9. Short-Term Clinical and Technical Outcomes of a Modified Zenker's Peroral Endoscopic Myotomy (Z-POEM) With Mucosal Flap Incision.

Author

Almario JAN, Mehta A, Shrigiriwar A, Fayyaz F, El-Sherbiny M, Essam K, Haggag H, Yousef K, Abdallatef A, Elkholy S, Canakis A, Kim RE, Yang D, Puga-Tejada M, Alcivar Vasquez J, Egas-Izquierdo M, Del Valle R, Cunto D, Baquerizo-Burgos J, Arevalo-Mora M, Robles-Medranda C, Borkowicz A, Kamiński MF, Lajin M, Kedia P, and Khashab MA

Abstract

Background: Zenker's diverticulum (ZD) per-oral endoscopic myotomy (Z-POEM) is an effective treatment for symptomatic (ZD). A modification to Z-POEM is the mucosal flap incision (MFI). We describe the technical and clinical success of patients who underwent Z-POEM with MFI., Methods: We included patients who underwent Z-POEM with MFI for ZD at 8 international centers. The primary outcome was the rate of clinical success, assessed by post-procedure Kothari-Haber symptom score (KHSS) without retreatment. Secondary outcomes included technical success, serious adverse events, and clinical recurrence with need for retreatment., Results: 36 patients (69% male, age 69 + 9 years) underwent Z-POEM with MFI for symptomatic ZD. Mean ZD size was 32 mm (+ 14). Clinical success was achieved in 35 (97%) cases. Median pre-procedure KHSS was 6 and median post-procedure KHSS was 1 (P <0.0001). Technical success was achieved in all cases. Mean procedure time was 57 minutes (+ 32), median follow up time was 196 days (IQR 39-499). There was one adverse event (3%) which was treated endoscopically., Conclusion: Z-POEM with MFI has a high rate of technical and clinical success. Prospective evaluation is needed to further validate this technique in patients with large ZD., Competing Interests: Dr. Ray Kim is a consultant for Medtronic, Cook Medical, and Apollo Endosurgery. Dr. Dennis Yang is a consultant for Olympus America, Fujifilm, Apollo Endosurgery, and Medtronic. Dr. Michael Kaminski is a consultant for Alfasigma USA, Fujifilm, and Olympus, and is a speaker for Boston Scientific. Dr. Prashant Kedia is a consultant for Olympus America, Boston Scientific, Medtronic, and Apollo Endosurgery. Dr. Mouen Khashab is a consultant for Boston Scientific, Olympus America, Medtronic, Apollo Endosurgery, and GI supply. The remaining Authors declare that there is no conflict of interest, (Thieme. All rights reserved.)

Published
2024
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