PMID- 36827992
OWN - NLM
STAT- MEDLINE
DCOM- 20230529
LR  - 20230727
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Linking)
VI  - 55
IP  - 6
DP  - 2023 Jun
TI  - Zenker's peroral endoscopic myotomy for management of large Zenker's 
      diverticulum.
PG  - 501-507
LID - 10.1055/a-2025-0715 [doi]
AB  - BACKGROUND: Zenker's diverticulum peroral endoscopic myotomy (zPOEM) is a 
      minimally invasive treatment strategy for Zenker's diverticulum, with excellent 
      results for management of small-to-moderate Zenker's diverticulum. We evaluated 
      its use in the management of large Zenker's diverticulum. METHODS: This was a 
      retrospective multicenter cohort study across 11 international centers including 
      adult patients with large Zenker's diverticulum >/= 40 mm treated by zPOEM between 
      March 2017 and March 2022. The primary outcome was clinical success (dysphagia 
      score </= 1 without need for further intervention). Secondary outcomes included 
      technical success (complete myotomy as intended), adverse events (AEs), and rate 
      of recurrence. RESULTS: 83 patients (male 62.7 %, mean age 72.6 [SD 11.5] years) 
      underwent zPOEM for treatment of large Zenker's diverticulum (median size 50 mm, 
      interquartile range [IQR] 41-55 mm, range 40-80 mm). The zPOEM procedure was 
      technically successful in 82 patients (98.8 %), with a mean procedure time of 
      48.7 (SD 23.2) minutes. Clinical success was achieved in 71 patients (85.5 %). 
      Median (IQR) symptom scores improved significantly from baseline for dysphagia (2 
      2 3 vs. 0 [0-2]; P < 0.001), regurgitation (3 2 3 4 vs. 0 [0-0]; P < 0.001), and 
      respiratory symptoms (2 [0-3] vs. 0 [0-0]; P < 0.001). Among patients achieving 
      clinical success, only one recurrence (1.4 %) was recorded during a median 
      follow-up of 12.2 months (IQR 3-28). Post-procedure AEs, all mild to moderate, 
      occurred in four patients (4.8 %). CONCLUSION: This study demonstrated safe and 
      effective use of zPOEM in the management of large Zenker's diverticulum.
CI  - Thieme. All rights reserved.
FAU - Zhang, Linda Y
AU  - Zhang LY
AD  - Johns Hopkins Medicine, Baltimore, Maryland, United States.
FAU - Hernandez Mondragon, Oscar
AU  - Hernandez Mondragon O
AD  - National Medical Center Century XXI, Mexico City, Mexico.
FAU - Pioche, Mathieu
AU  - Pioche M
AD  - Hospital Edouard Herriot, Lyon, Rhone-Alpes, France.
FAU - Steinway, Steven N
AU  - Steinway SN
AD  - Johns Hopkins Medicine, Baltimore, Maryland, United States.
FAU - Nieto, Jose
AU  - Nieto J
AD  - Borland Groover, Jacksonville, Florida, United States.
FAU - Ujiki, Michael B
AU  - Ujiki MB
AD  - NorthShore University Health System, Evanston, Illinois, United States.
FAU - VanDruff, Vanessa N
AU  - VanDruff VN
AD  - NorthShore University Health System, Evanston, Illinois, United States.
FAU - Kim, Raymond E
AU  - Kim RE
AD  - Division of Gastroenterology and Hepatology, University of Maryland School of 
      Medicine, Baltimore, Maryland, United States.
FAU - Canakis, Andrew
AU  - Canakis A
AUID- ORCID: 0000-0002-6646-6693
AD  - Division of Gastroenterology and Hepatology, University of Maryland School of 
      Medicine, Baltimore, Maryland, United States.
FAU - Tantau, Marcel
AU  - Tantau M
AD  - "Prof Dr Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 
      Cluj-Napoca, Cluj, Romania.
FAU - Tantau, Alina
AU  - Tantau A
AD  - Gastroenterology and Hepatology Medical Center, Cluj-Napoca, Cluj, Romania.
FAU - Pop, Anamaria
AU  - Pop A
AD  - Gastroenterology and Hepatology Medical Center, Cluj-Napoca, Cluj, Romania.
FAU - Jacques, Jeremie
AU  - Jacques J
AD  - Hopital Dupuytren, Service de Gastroenterologie, Limoges, France.
FAU - Lajin, Michael
AU  - Lajin M
AUID- ORCID: 0000-0001-7376-3461
AD  - Sharp HealthCare, San Diego, California, United States.
FAU - Desai, Pankaj
AU  - Desai P
AD  - Department of Gastroenterology, Endoscopy Unit, SIDS Hospitals, Surat, India.
FAU - Shrigiriwar, Apurva
AU  - Shrigiriwar A
AD  - Johns Hopkins Medicine, Baltimore, Maryland, United States.
FAU - Bejjani, Michael
AU  - Bejjani M
AD  - Johns Hopkins Medicine, Baltimore, Maryland, United States.
FAU - Kumta, Nikhil A
AU  - Kumta NA
AD  - Icahn School of Medicine at Mount Sinai, New York, New York, United States.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Johns Hopkins Medicine, Baltimore, Maryland, United States.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230224
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
SB  - IM
MH  - Adult
MH  - Humans
MH  - Male
MH  - Aged
MH  - *Zenker Diverticulum/surgery
MH  - *Deglutition Disorders/etiology/surgery
MH  - Cohort Studies
MH  - Length of Stay
MH  - *Myotomy/adverse effects
MH  - Treatment Outcome
MH  - Retrospective Studies
MH  - Esophagoscopy/adverse effects/methods
COIS- J. Nieto is a consultant for Boston Scientific, Olympus, and ConMed. M. Ujiki is 
      a board member for Boston Scientific, a consultant for Olympus and Cook, and has 
      received grant funding from Medtronic and payments for lectures from Medtronic, 
      Erbe, and Gore. R.E. Kim is a consultant for Medtronic and Cook Medical. N.A. 
      Kumta is a consultant for Apollo Endosurgery, Boston Scientific, Olympus, 
      Intuitive Surgical, and SafeHeal. M.A. Khashab is a consultant for Boston 
      Scientific, Olympus America, Medtronic, Apollo Endosurgery, Pentax, and GI 
      Supply; he also receives royalties from UpToDate and Elsevier. L.Y. Zhang, O. 
      Hernandez Mondragon, M. Pioche, S.N. Steinway, V.N. VanDruff, A. Canakis, M. 
      Tantau, A. Tantau, A. Pop, J. Jacques, M. Lajin, P. Desai, A. Shrigiriwar, and M. 
      Bejjani declare that they have no conflict of interest.
EDAT- 2023/02/25 06:00
MHDA- 2023/05/29 06:42
CRDT- 2023/02/24 18:58
PHST- 2023/05/29 06:42 [medline]
PHST- 2023/02/25 06:00 [pubmed]
PHST- 2023/02/24 18:58 [entrez]
AID - 10.1055/a-2025-0715 [doi]
PST - ppublish
SO  - Endoscopy. 2023 Jun;55(6):501-507. doi: 10.1055/a-2025-0715. Epub 2023 Feb 24.