Endoscopy 2021; 53(07): 722-726
DOI: 10.1055/a-1276-0219
Innovations and brief communications

Impact of prior treatment on feasibility and outcomes of Zenker’s peroral endoscopic myotomy (Z-POEM)

Omid Sanaei
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
2  Department of Medicine, MedStar Health System, Baltimore, Maryland, USA
,
Yervant Ichkhanian
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Oscar V. Hernández Mondragón
3  Division of Endoscopy, Specialties Hospital, National Medical Center Century XXI, Mexico City, Mexico
,
Jose Nieto
4  Division of Gastroenterology and Hepatology, Borland Groover Clinic, Jacksonville, Florida, USA
,
Arunkumar Krishnan
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Marcel Tantau
5  Gastroenterology and Hepatology Medical Center, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
,
Alina Tantau
5  Gastroenterology and Hepatology Medical Center, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
,
Pankaj N. Desai
6  SIDS Hospital and Research Center, Surat, India
,
Gregory G. Ginsberg
7  Endoscopic Services, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
,
Monica Saumoy
7  Endoscopic Services, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
,
Ameya Deshmukh
4  Division of Gastroenterology and Hepatology, Borland Groover Clinic, Jacksonville, Florida, USA
,
Mikhail Attaar
8  Department of Surgery, Grainger Center of Simulation and Innovation, NorthShore University Health System, Evanston, Illinois, USA
,
Jad Farha
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Manol Jovani
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Sarah S. Al-Ghamdi
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Michael Ujiki
8  Department of Surgery, Grainger Center of Simulation and Innovation, NorthShore University Health System, Evanston, Illinois, USA
,
Mouen A. Khashab
1  Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
› Author Affiliations

Abstract

Background Zenker’s peroral endoscopic myotomy (Z-POEM) is a novel procedure for the management of symptomatic Zenker’s diverticulum. This study aims to report the technical feasibility and outcomes of Z-POEM in the management of Zenker’s diverticulum after prior failed interventions.

Methods Patients with persistent or recurrent symptoms after prior endoscopic and/or surgical intervention for Zenker’s diverticulum were retrospectively included. The primary outcome was clinical success, defined as complete or near complete resolution of dysphagia (dysphagia score of 0 or 1) without the need for repeat endoscopic or surgical intervention during follow-up.

Results Z-POEM was technically successful in 30/32 patients (93.8 %). Clinical success was achieved in 29/30 patients (96.7 %), and Z-POEM significantly reduced the median (interquartile range [IQR]) dysphagia score of patients from 2 (1 – 2) to 0 (0) (P < 0.001) over a median duration of follow up of 166 days (IQR 39 – 566). Four patients (12.5 %) had adverse events (two inadvertent mucosotomies and two leaks found on post-procedural esophagrams).

Conclusion Z-POEM is feasible, safe, and effective in the majority of patients with recurrent symptoms after prior surgical or endoscopic interventions.

Supplementary material



Publication History

Received: 27 May 2020

Accepted: 17 September 2020

Publication Date:
23 October 2020 (online)

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