S-POEM in treatment of achalasia and esophageal epiphrenic diverticula – single center experience

Demeter, Michal; Ďuríček, Martin; Vorčák, Martin; Hyrdel, Rudolf; Kunda, Rastislav; Bánovčin, Peter

doi:10.1080/00365521.2020.1745881

Cited by 25 publications

(29 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Side effects associated with insufflation are frequently asymptomatic and have an incidence between 0% and 72% [3]. If symptomatic, pneumoperitoneum or pneumothorax can be drained, whereas subcutaneous emphysema rarely needs to be treated [3,9,10,42,47,48]. In our study, CO2 was used in all interventions, which has contributed to the absence of symptoms in most patients, as it is easily and hastily absorbed.…”

Section: Discussionmentioning

confidence: 84%

See 1 more Smart Citation

POEM: Five Years of Experience in a Single East European Center

Tefas

Boroș²,

Ciobanu

et al. 2020

JGLD

View full text Add to dashboard Cite

Background and Aims: Achalasia is an esophageal motility disorder with many available therapies. Peroral endoscopic myotomy (POEM) is a therapeutic alternative to surgical myotomy, harboring significant potential short term advantages. Our aim was to analyze a single-series POEM’s learning curve, safety and efficiency over short, medium and long-terms in an East European Center. Methods: This observational, prospective study was carried out in the Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. Patients with symptomatic achalasia (Eckardt score>3) and pre-op evaluations consistent with the diagnosis of achalasia were included. All POEMs were performed by a highly skilled endoscopist. All patients were allowed to eat 48 hours after POEM. An esophagography was performed in all patients to exclude any leakage. The patients were asked to return for follow-up at established intervals: 1 month, 6 months, 12 months, and annually thereafter. Results: 136 patients were included with an average duration of symptomatology of 36.75 months. The procedure was technically successful in all patients, while a clinical success rate was achieved in 87.5% (n=119) of patients after one POEM session. The success rate was 92.64% after 6 months, 91.17% after one year, 88.9% after 2 years, and 87.5% after 3 years or more; 12.5% of patients required additional treatment. Eighteen patients (13.23%) presented major early complications. Gastroesophageal reflux disease was encountered in 16 patients immediately after POEM and in 22 patients at subsequent follow-ups. Conclusion: POEM is a safe and effective minimally invasive therapeutic option which can substitute surgical myotomy, having a high success rate and a low rate of adverse events in short, medium and long-term.

show abstract

Section: Discussionmentioning

confidence: 84%

“…Mean hospital stay was 4.08 days (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. No surgical conversion was required and the mortality rate was 0.…”

Section: Resultsmentioning

confidence: 99%

POEM: Five Years of Experience in a Single East European Center

Tefas

Boroș²,

Ciobanu

et al. 2020

JGLD

View full text Add to dashboard Cite

show abstract

“…Achalasia has traditionally been considered the primary esophageal motility disorder associated with esophageal diverticula, and propagating peristalsis, often with hypercontractility, was the predominant motility pattern observed with highresolution manometry 22 in patients with esophageal diverticula in recent studies. Surgery of the lower esophageal sphincter together with diverticulectomy 23 was recently reported in diverticulum with motor disorders to treat symptoms and prevent recurrence of the diverticulum. However, esophageal diverticulum with fistula is extremely rare, and manometric evaluation would be needed to explore the association between esophageal dynamics disorders and BEF secondary to esophageal diverticulum.…”

Section: Discussionmentioning

confidence: 99%

Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

2021

View full text Add to dashboard Cite

Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.

show abstract

“…Besides ZD, endoscopic division of septum has also been utilized in cases with epiphrenic diverticula and termed as diverticular per-oral endoscopic myotomy (D-POEM). [57][58][59][60] The technique of D-POEM has been described in detail by the authors of this review. 61 The standard technique of D-POEM involves division of diverticulum septum along with lower esophageal sphincter (LES) myotomy in cases with coexisting achalasia cardia.…”

Section: Per-oral Endoscopic Myotomy For Esophageal Diverticula: Zenker's Diverticulum and Epiphrenic Diverticulummentioning

confidence: 99%

Third-Space Endoscopy: Recent Updates

Nabi

Reddy

2021

Journal of Digestive Endoscopy

View full text Add to dashboard Cite

Third space or submucosal space is a potential space which on expansion allows the endoscopist to execute a multitude of therapeutic procedures for various gastrointestinal diseases like achalasia, subepithelial tumors, Zenker’s diverticulum, and refractory gastroparesis. Third space was first utilized for performing endoscopic myotomy in cases with achalasia cardia about a decade ago. Since then, the field of submucosal endoscopy has witnessed an exponential growth. The present review focuses on recent advances in the field of third-space endoscopy. With regard to per-oral endoscopic myotomy (POEM) in achalasia cardia, several recent studies have evaluated the long-term outcomes of POEM, compared endoscopic myotomy with pneumatic dilatation (PD) and surgical myotomy, and evaluated the outcomes of short- versus long-esophageal myotomy. In addition, the utility of multiple dose antibiotic prophylaxis to prevent infections after POEM has been questioned. Overall, the results from these studies indicate that POEM is a durable treatment modality, equally effective to Heller’s myotomy and superior to PD. With regard to gastric-POEM (G-POEM), recent studies suggest only modest efficacy in cases with refractory gastroparesis. Therefore, quality studies are required to identify predictors of response to optimize the outcomes of G-POEM in these cases. Another third-space endoscopy procedure that has gained popularity is endoscopic division of septum in cases with esophageal diverticula including Zenker’s POEM and epiphrenic diverticula POEM (Z-POEM and D-POEM, respectively). The technique of diverticulotomy using the principles of submucosal endoscopy appears safe and effective in short term. Data on term outcomes are awaited and comparative trials with flexible endoscopic myotomy required. Per-rectal endoscopic myotomy (PREM) is the most recent addition to third space endoscopy procedures for the management of short-segment Hirschsprung’s disease. Limited data suggest that PREM may be a promising alternative surgery in these cases. However, quality studies with long-term follow-up are required to validate the outcomes of PREM.

show abstract

S-POEM in treatment of achalasia and esophageal epiphrenic diverticula – single center experience

Cited by 25 publications

References 13 publications

POEM: Five Years of Experience in a Single East European Center

POEM: Five Years of Experience in a Single East European Center

Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

Third-Space Endoscopy: Recent Updates

Contact Info

Product

Resources

About