Endoscopy 2019; 51(04): 346-349
DOI: 10.1055/a-0759-1428
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

An international study on the use of peroral endoscopic myotomy (POEM) in the management of esophageal diverticula: the first multicenter D-POEM experience

Juliana Yang
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Xianhui Zeng
2  Division of Gastroenterology and Hepatology, West China Medical Center of Sichuan University, Chengdu, Sichuan, China
,
Xianglei Yuan
2  Division of Gastroenterology and Hepatology, West China Medical Center of Sichuan University, Chengdu, Sichuan, China
,
Kenneth Chang
3  Division of Gastroenterology, University of California Irvine, Irvine, California, USA
,
Omid Sanaei
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Lea Fayad
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Vivek Kumbhari
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Vikesh Singh
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Anthony N. Kalloo
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Bing Hu
2  Division of Gastroenterology and Hepatology, West China Medical Center of Sichuan University, Chengdu, Sichuan, China
,
Mouen A. Khashab
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
› Author Affiliations
Further Information

Publication History

submitted 08 May 2018

accepted after revision: 14 September 2018

Publication Date:
19 November 2018 (online)

Abstract

Background The aim of this study is to report a novel, multicenter experience with the diverticular peroral endoscopic myotomy (D-POEM) technique in the management of esophageal diverticula.

Methods This is a multicenter, international, retrospective study involving three centers. D-POEM was performed using the principles of submucosal endoscopy.

Results A total of 11 patients with an esophageal diverticulum (Zenker’s 7, mid-esophagus 1, epiphrenic 3) were included. The mean size of the esophageal diverticula was 34.5 mm. The overall technical success rate of D-POEM was 90.9 %, with a mean procedure time of 63.2 minutes. There were no adverse events. Clinical success was achieved in 100 % (10 /10), with a decrease in mean dysphagia score from 2.7 to 0.1 (P < 0.001) during a median follow-up of 145 days (interquartile range 126 – 273).

Conclusion Endoscopic management of esophageal diverticula using the novel technique of D-POEM appears promising. This first case series on D-POEM suggests that the procedure is feasible, safe, and effective in the management of esophageal diverticula. D-POEM offers the distinct advantage of ensuring a complete septotomy. Larger studies are needed to confirm these intriguing results.