Comparison of Zenker’s per-oral endoscopic myotomy (Z-POEM) with standard flexible endoscopic septotomy for Zenker’s diverticulum: a prospective study with 2-year follow-up

Background Flexible endoscopic therapy of Zenker’s diverticulum using submucosal tunneling (Z-POEM) similar to esophageal Per-Oral Endoscopic Myotomy (POEM) is becoming increasingly common. However, data comparing Z-POEM with traditional flexible endoscopic septotomy (FES) are sparse. The aim of this study was to compare outcomes of Z-POEM with traditional FES over a medium-term follow-up period. Methods This was a prospective study of patients who underwent Z-POEM for treatment of Zenker’s diverticulum between 2018 and 2020 at a tertiary academic medical center compared to prior patients who had FES (between 2015 and 2018). Procedural characteristics and clinical outcomes (technical and clinical success, and adverse events) were compared between patients who underwent each treatment. Results A total of 28 patients underwent ZD therapy during the study period. 13 patients (mean age 70 years; 77% male) underwent Z-POEM and 15 patients (mean age 72 years; 73% male) underwent traditional FES. The mean Zenker’s diverticulum size was 2.4 ± 0.6 cm in the ZPOEM group vs 2.5 ± 0.8 cm in the FES group. The mean procedure time was similar between groups: 43.9 min (range 26–66) in the Z-POEM group and 60.2 min (range 25–92) in the traditional FES group (t = 1.74 p = 0.19). Overall technical success was seen in 100% of patients. There was one adverse event in the FES group (dehydration resulting in near-syncope) (1/28, 3.6%). Overall clinical success was seen in 92.8% (26/28) of patients and was not significantly different between groups (Z-POEM; 13/13, 100% vs FES; 13/15, 86.7%, t = − 1.36 p = 0.18). Conclusion This prospective study suggests that ZPOEM is an effective technique for the treatment of Zenker’s diverticulum with no significant differences in clinical outcomes or adverse event rates when compared to traditional FES..

Medienart:	Artikel

Erscheinungsjahr:	2023
Erschienen:	2023

Enthalten in:	Zur Gesamtaufnahme - volume:37
Enthalten in:	Surgical endoscopy - 37(2023), 9 vom: 05. Juni, Seite 6818-6823

Sprache:	Englisch

Beteiligte Personen:	Swei, Eric [VerfasserIn] Pokala, Sridevi K. [VerfasserIn] Menard-Katcher, Paul [VerfasserIn] Wagh, Mihir S. [VerfasserIn]

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© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:	10.1007/s00464-023-10136-4

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PPN (Katalog-ID):	OLC2145258116