Submucosal Tunnelling Endoscopic Septum Division (Z-Poem) for Zenker's Diverticulum: A New Emerging Technique Compared to Conventional Endoscopic Septotomy

Desai, Pankaj; Kabrawala, Mayank; Nandwani, Subhash; Mehta, Rajiv; Patel, Chintan; Kalra, Parika; Prajapati, Ritesh; Patel, Naiya

doi:10.1055/s-0039-1681534

Cited by 3 publications

(13 citation statements)

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“…The Z-POEM group had a longer hospital stay with a higher clinical success rate (100% vs. 80%) than the standard flexible endoscopic septotomy group [ 28 ]. Similar findings were reported in the abstract by Desai et al, who conducted a retrospective study comparing these two endoscopic techniques [ 29 ]. The follow-up duration in this case series was 18 months, with a significantly higher recurrence rate in the standard endoscopic diverticulotomy group (37.5% vs. 0%) and fewer adverse events in the Z-POEM group (14% vs. 62.5%) [ 29 ].…”

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

confidence: 89%

“…Similar findings were reported in the abstract by Desai et al, who conducted a retrospective study comparing these two endoscopic techniques [ 29 ]. The follow-up duration in this case series was 18 months, with a significantly higher recurrence rate in the standard endoscopic diverticulotomy group (37.5% vs. 0%) and fewer adverse events in the Z-POEM group (14% vs. 62.5%) [ 29 ]. Further prospective and randomized controlled studies are needed to substantiate these findings.…”

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

confidence: 89%

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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 Endoscopsupporting

confidence: 89%

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

confidence: 89%

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

et al. 2020

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“…Two studies out of 20 were prospective (6,7), 11 were retrospective (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), 6 case reports (19)(20)(21)(22)(23)(24) and 1 clinical review (25).…”

Section: Resultsmentioning

confidence: 99%

“…Of the retrospective studies, 6 were comparative studies between ESD and other treatment techniques, such as the flexible endoscopic treatment (9), CO 2 laser (11)(12)(13), open surgery (12,14,15) or a new technique called MTORD (transoral resection of diverticulum) (15). About Z-POEM we reviewed 6 case reports, 1 retrospective study and 2 comparative retrospective studies where the Z-POEM's outcomes were compared to the classic endoscopic septotomy (17,18). All the studies about ESD are summarized in the Table 1 and those about Z-POEM in Table 2.…”

Section: Resultsmentioning

confidence: 99%

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

Cerchione¹,

Olivari²,

Cossu³

et al. 2020

Shanghai Chest

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BackgroundZenker's diverticulum (ZD) is a protrusion of the pharyngeal mucosa and submucosa through Killian's triangle, between the inferior pharyngeal constrictor muscle and the cricopharyngeal muscle. The underling mechanism of formation is the pulsion against a dyscinetic upper esophageal sphincter (UES). It is a rare disorder and mostly affects elderly people, but still, it is the most frequent esophageal diverticulum. Its incidence is reported to be

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Peroral Endoscopic Myotomy for the Treatment of Esophageal Diverticula

Facciorusso

Ramai

Ichkhanian

et al. 2021

Journal of Clinical Gastroenterology

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Background: There is limited evidence on the efficacy of peroral endoscopic myotomy (POEM) in patients with esophageal diverticula.Aims: This meta-analysis aimed to assess the efficacy and safety profile of POEM in patients with Zenker (ZD) and epiphrenic diverticula.Methods: With a literature search through August 2020, we identified 12 studies (300 patients) assessing POEM in patients with esophageal diverticula. The primary outcome was treatment success. Results were expressed as pooled rates and 95% confidence intervals.Results: Pooled rate of technical success was 95.9% (93.4%-98.3%) in ZD patients and 95.1% (88.8%-100%) in patients with epiphrenic diverticula. Pooled rate of treatment success was similar for ZD (90.6%, 87.1%-94.1%) and epiphrenic diverticula (94.2%, 87.3%-100%). Rates of treatment success were maintained at 1 year (90%, 86.4%-97.4%) and 2 years (89.6%, 82.2%-96.9%) in ZD patients. Pooled rate of symptom recurrence was 2.6% (0.9%-4.4%) in ZD patients and 0% in patients with epiphrenic diverticula. Pooled rates of adverse events and severe adverse events were 10.6% (4.6%-16.6%) and 3.5% (0%-7.4%) in ZD and 8.4% (0%-16.8%) and 8.4% (0%-16.8%) in epiphrenic diverticula, respectively. Conclusion:POEM represents an effective and safe therapy for the treatment of esophageal diverticula.

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Submucosal Tunnelling Endoscopic Septum Division (Z-Poem) for Zenker's Diverticulum: A New Emerging Technique Compared to Conventional Endoscopic Septotomy

Cited by 3 publications

References 0 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

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

Peroral Endoscopic Myotomy for the Treatment of Esophageal Diverticula

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