Endoscopic management of Zenker’s diverticulum: stapling vs. Z-POEM

Cerchione, Raffaele; Olivari, Greta; Cossu, Andrea; Barbieri, Lavinia; Palucci, Marco; Cinelli, Lorenzo; Puccetti, Francesco; Rosati, Riccardo

doi:10.21037/shc.2020.01.04

Cited by 4 publications

(3 citation statements)

References 23 publications

(76 reference statements)

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“…Cerchione et al performed an indirect comparison of Z-POEM and the surgical stapled diverticulostomy technique and reported a lower recurrence rate in the Z-POEM group than in the surgical group (1% vs. 10%) [ 30 ]. There were no significant differences in terms of clinical success and complications.…”

Section: Outcomes Of Zenker’s Diverticulum Using the Peroral Endoscopmentioning

confidence: 99%

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Role of Peroral Endoscopic Myotomy (POEM) in the Management of Esophageal Diverticula

et al. 2020

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Esophageal diverticula are uncommon; however, when present, they can cause symptoms of dysphagia, regurgitation, and chest pain. Based on location and pathophysiological characteristics, they are classified as pulsion-and traction-type diverticula. In the past, the open surgical approach was the only treatment available; however, in the past few decades, transoral incisionless approaches in the form of rigid and flexible endoscopy have gained popularity. Diverticular peroral endoscopic myotomy has emerged as an alternative treatment option. In this paper, we reviewed the role of peroral endoscopic myotomy as a treatment option for different types of esophageal diverticula. Although a safe and effective procedure, this novel submucosal tunneling technique for the treatment of esophageal diverticula requires further validation, and head-to-head comparisons between the different approaches for the treatment of esophageal diverticula are warranted.

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Section: Outcomes Of Zenker’s Diverticulum Using the Peroral Endoscopmentioning

confidence: 99%

“…There were no significant differences in terms of clinical success and complications. Both procedures were safe, and adverse events occurred in 2%–6% of the cases [ 30 ].…”

Section: Outcomes Of Zenker’s Diverticulum Using the Peroral Endoscopmentioning

confidence: 99%

Role of Peroral Endoscopic Myotomy (POEM) in the Management of Esophageal Diverticula

et al. 2020

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“…Commonly used endoscopic techniques are less invasive than open surgery with improved morbidity rates. However, a significant concern is the high rate of recurrence that is between 7 and 24% [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Modern approaches to treating Zenker's diverticulum

Fair

Ward

2023

Current Opinion in Gastroenterology

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Purpose of review Zenker's diverticulum is the most common hypopharyngeal diverticulum. Patients with Zenker's diverticulum may require surgical treatment, which can be performed via an open surgical or endoscopic approach. A new endoscopic technique that is now being used for Zenker's diverticulum is Zenker Per Oral Endoscopic Myotomy (ZPOEM). ZPOEM has demonstrated promising results, and may have certain advantages over the other endoscopic treatments. The purpose of this review article is to evaluate the various surgical and endoscopic treatment options for Zenker's diverticulum, while specifically focusing on ZPOEM. Recent findings Endoscopic approaches have become the first-line therapy for Zenker's diverticulum, replacing the traditional open approach, because of the less invasive nature of the endoscopic procedures, improved rates of morbidity, and quicker recovery times. Recent studies evaluating ZPOEM have demonstrated that it is technically feasible and highly efficacious. In addition, it has a low rate of clinical recurrence and adverse events. When compared with other endoscopic techniques for treating Zenker's diverticulum, ZPOEM appears to have improved outcomes. Summary ZPOEM has been recently implemented in the algorithm of Zenker's diverticulum management. Further comparative and prospective studies focusing on long-term follow-up are still needed; however, ZPOEM appears to be an excellent option for patients suffering from Zenker's diverticulum.

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Per-oral endoscopic myotomy is a safe and effective treatment for Zenker’s diverticulum: a retrospective multicenter study

Ward

Fair

Misenhimer

et al. 2023

Diseases of the Esophagus

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Summary Zenker per-oral endoscopic myotomy (ZPOEM) has become a promising technique for Zenker’s diverticulum (ZD). The aim of this study was to add to the limited body of literature evaluating the safety and efficacy of ZPOEM. A prospectively maintained database was retrospectively reviewed to identify patients who underwent ZPOEM at two separate institutions between January 2020 and January 2022. Demographics, preoperative and postoperative clinical data, intraoperative data, adverse events, and length of stay were analyzed. A total of 40 patients (mean age 72.5 years, 62.5% male) were included. Average operative time was 54.7 minutes and average length of stay was 1.1 days. There were three adverse events, and only one was related to the technical aspects of the procedure. Patients showed improvement in the Functional Oral Intake Scale (FOIS) scores at 1 month (5 vs 7, p < 0.0001). The median FOIS scores remained 7 at both 6 and 12 months, although this improvement was not statistically significant at these time intervals (p = 0.46 and 0.37, respectively). Median dysphagia scores were decreased at 1 (2.5 vs 0, p < 0.0001), 6 (2.5 vs 0, p < 0.0001), and 12 months (2.5 vs 0, p = 0.016). The number of patients reporting ≥1 symptom was also decreased at 1 (40 vs 9, p < 0.0001) and 6 months (40 vs 1, p = 0.041). Although the number of patients reporting ≥1 symptom remained consistent at 12 months, this was not statistically significant (40 vs 1, p = 0.13). ZPOEM is a safe and highly effective treatment for the management of ZD.

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Endoscopic management of Zenker’s diverticulum: stapling vs. Z-POEM

Cited by 4 publications

References 23 publications

Role of Peroral Endoscopic Myotomy (POEM) in the Management of Esophageal Diverticula

Role of Peroral Endoscopic Myotomy (POEM) in the Management of Esophageal Diverticula

Modern approaches to treating Zenker's diverticulum

Per-oral endoscopic myotomy is a safe and effective treatment for Zenker’s diverticulum: a retrospective multicenter study

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