Project description:Peroral endoscopic myotomy (POEM) is an emerging technique in the treatment of Zenker's diverticulum (ZD). This study aimed to analyze the feasibility of Zenker's POEM (Z-POEM) in a multicenter setting and assess its performance using a validated Kothari-Haber Scoring System newly developed for symptom measurement in ZD. This was a multicenter retrospective study involving three Polish tertiary referral endoscopic units. The data of consecutive patients with symptomatic ZD treated with Z-POEM in Poland between May 2019 and August 2020 were retrieved and analyzed. Primary outcome measures were technical success and clinical success rate (<3 points in Kothari-Haber Score at 2-3 months follow-up). Secondary outcome measures included procedures' duration, length of hospital stay, and adverse events. 22 patients with symptomatic ZD were included. The mean age was 67.6 (±10.7) years, and 14 (63.6%) were male. All but two patients were treatment naïve. The average size of the ZD was 30 mm (IQR, 24-40 mm). Technical success was achieved in all patients (100%), whereas clinical success was 90.9%. The average Kothari-Haber Score was 6.35 before treatment and has dropped to 0.65 after the treatment (p < 0.0001). The mean procedure time was 48.8 (±19.3) minutes, and the median length of hospital stay was 2 days (IQR, 2-3). Three patients (13.6%) had post-procedural emphysema, of which two were mild and self-resolving (9.1%), and one was moderate (4.5%) and complicated with laryngeal edema and prolonged intubation. This feasibility study suggests that Z-POEM is a highly effective and safe treatment for ZD, particularly among treatment-naïve patients. Comparative studies with other treatment modalities over longer follow-up are warranted.

| S-EPMC7826711 | biostudies-literature

Endoscopic vacuum therapy for nonhealing cavity with fistulous tract after peroral endoscopic myotomy for Zenker's diverticulum.

Project description:Video 1Endoscopic vacuum therapy for nonhealing cavity with fistulous tract after peroral endoscopic myotomy for Zenker diverticulum.

| S-EPMC10928134 | biostudies-literature

Flexible endoscopic management of Zenker's diverticulum.

Project description: Not available

| S-EPMC5965726 | biostudies-literature

Early experience with use of an endoscopic "hot" scissor-type knife for myotomy during per-oral endoscopic myotomy procedure.

Project description:Background and aimsCurrent devices used for per-oral endoscopic myotomy (POEM) function predominantly to either cut tissue or coagulate vessels. When bleeding vessels are encountered within the submucosa or muscle, dedicated coagulation grasping devices are often necessary. An endoscopic "hot" scissor-type knife is available that combines coagulation and cutting functions. Scissor-type knives may therefore be helpful during the POEM procedure.MethodsWe report 4 cases of achalasia that were treated by the POEM procedure using the Stag Beetle scissor-type knife for myotomy. Patients were identified from a prospectively maintained database of patients undergoing POEM at our center between September and October 2017. A single operator (K.J.C.) performed all of the procedures using both a hybrid knife and an SB knife. Demographic and clinical data were collected for all patients.ResultsAll 4 POEM procedures were performed successfully without any adverse events. Only 3 spontaneous bleeding episodes occurred among the 4 procedures, and no perforation occurred. The patients were all doing very well at clinic follow-up at 4 weeks.ConclusionsThe technique of using the SB knife during myotomy during the POEM procedure is feasible and appears safe. Muscle tissue and blood vessels can be coagulated and cut simultaneously, reducing bleeding and improving control. Further comparative studies are warranted to evaluate the efficacy, safety, and cost effectiveness against existing techniques.

| S-EPMC6470349 | biostudies-literature

Per-oral endoscopic myotomy and simultaneous diverticuloseptotomy in coincident epiphrenic diverticulum and achalasia.

Project description: Not available

| S-EPMC6362324 | biostudies-literature

A staged approach to submucosal tunnel entry during per-oral endoscopic myotomy.

Project description: Not available

| S-EPMC5990344 | biostudies-literature

Peroral endoscopic myotomy with diverticulum resection.

Project description: Not available

| S-EPMC7652700 | biostudies-literature