Endoscopy 2020; 52(S 01): S142
DOI: 10.1055/s-0040-1704437
ESGE Days 2020 ePoster Podium presentations
Thursday, April 23, 2020 11:00 – 11:30 Endoscopic treatment of Zenker 1 ePoster Podium 6
© Georg Thieme Verlag KG Stuttgart · New York

Z POEM FOR ZENKER´S DIVERTICULUM: A SINGLE CENTRE DATA OF 16 CASES

P Desai
1   Surat Institute of Digestive Sciences, Endoscopy, Surat, India
,
M Kabrawala
2   Surat Institute of Digestive Sciences, Surat, India
,
C Patel
2   Surat Institute of Digestive Sciences, Surat, India
,
P Kalra
2   Surat Institute of Digestive Sciences, Surat, India
,
R Prajapati
2   Surat Institute of Digestive Sciences, Surat, India
,
N Patel
2   Surat Institute of Digestive Sciences, Surat, India
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims We studied 16 cases of Zenker’s diverticulum causing dysphagia and regurgitation treated with Z POEM. Traditionally septotomy has recurrence rate of around 20 to 30%%. Hence we attempted to see if Z POEM reduces recurrence.

    Methods General anaesthesia. Left lateral or supine position depending on the septum. Mucosal injection 1 cms proximal to septum, entry in tunnel after 1.5 cms incision. Septum isolated from esophageal and diverticular side till the base of septum. Septum divided using an insulated tip knife completely. Hemostasis secured. Incision closed. Patient nil orally for 24 hours . Gastrograffin study to see for any leak and ease of swallow. Patient started on liquids.

    Results Total Number of patients: 16

    Male: Female: 10: 6

    Charlson Comorbidity index: Average to High Risk

    Major Symptoms: Dysphagia- 14, Regurgitation -2

    Average Procedure Time - 51min (40 - 75min)

    Length Of Diverticulum: 32 mm (22 to 60 mm)

    Dysphagia Score Prior to Z POEM - Average Score: 3 (10 had 3, 2 had 4 and 4 had 2)

    0=normal diet/no dysphagia,

    1=some solid foods,

    2=semi solid food,

    3=liquid food only,

    4=unable to swallow anything

    (total dysphagia)

    Results Immediate Reduction in Dysphagia Score: 0.3 (13 had 0, 4 had 1)

    Resolution of Diverticulum on Gastrograffin: 12/16 (75%)

    Length of Hospital Stay: 1.3 days (12 - 1 night stay, 4 - 2 nights)

    Length of Septotomy: 31 mm (21 to 59 mm)

    Complications: Bleeding Intra op mild - 1/16 (6.3%)

    Capno mediastinum/peritoneum: 2/16 (12.5%)

    Symptom Recurrence: 3 months - 0/16

    6 months- 0/16

    12 months- 1/16(6.3%)

    18 months- 1/16 (6.3%)

    Conclusions Z POEM is an effective technique for Zenker’s diverticulum. Very good relief of dysphagia, very low complication rate. Recurrence rates in early follow up is very low.


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