PMID- 37397859
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230704
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 11
IP  - 6
DP  - 2023 Jun
TI  - Long-term outcomes of Zenker's peroral endoscopic myotomy (Z-POEM) for treatment 
      of Zenker's diverticulum.
PG  - E607-E612
LID - 10.1055/a-2067-9105 [doi]
AB  - Background and study aims  Z-POEM is now an established therapy for symptomatic 
      Zenker's diverticulum (ZD). Short-term follow-up of up to 1-year post Z-POEM 
      suggests excellent efficacy and safety; however, long-term outcomes are not 
      known. Thus, we sought to report on longer-term outcomes (>/= 2 years) following 
      Z-POEM for treatment of ZD. Patients and methods  This was an International 
      multicenter retrospective study at eight institutions across North America, 
      Europe, and Asia over a 5-year period (from December 3, 2015 to March 13, 2020) 
      of patients who underwent Z-POEM for management of ZD with a minimum 2-year 
      follow-up. The primary outcome was clinical success, defined as improvement in 
      dysphagia score to </= 1 without need for further procedures during the first 6 
      months. Secondary outcomes included rate of recurrence in patients initially 
      meeting clinical success, rate of reintervention, and adverse events (AEs). 
      Results  A total of 89 patients (male 57.3 %, mean age 71 +/- 12 years) underwent 
      Z-POEM for treatment of ZD (mean diverticulum size was 3.4 +/- 1.3 cm). Technical 
      success was achieved in 97.8 % of patients (n = 87) with a mean procedure time of 
      43.8 +/- 19.2 minutes. The median post-procedure hospital stay was 1 day. There 
      were eight AEs (9 %) (3 mild, 5 moderate). Overall, clinical success was achieved 
      in 84 patients (94 %). Mean dysphagia, regurgitation, and respiratory scores all 
      improved dramatically from 2.1 +/- 0.8, 2.8 +/- 1.3, and 1.8 +/- 1.6 pre-procedure to 
      0.13 +/- 0.5, 0.11 +/- 0.5, and 0.05 +/- 0.4, respectively, post-procedure at most 
      recent follow-up (all P  < 0.0001). Recurrence occurred in six patients (6.7 %) 
      during a mean length of follow-up of 37 months (range 24 to 63 months). 
      Conclusions  Z-POEM is a highly safe and effective treatment for Zenker's 
      diverticulum with durable treatment effect to at least 2 years.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Steinway, Steven
AU  - Steinway S
AD  - Johns Hopkins Medicine, Gastroenterology and Hepatology, Baltimore, Maryland, 
      United States.
FAU - Zhang, Linda
AU  - Zhang L
AD  - Johns Hopkins Medicine, Gastroenterology and Hepatology, Baltimore, Maryland, 
      United States.
FAU - Amundson, Julia
AU  - Amundson J
AD  - University of Chicago Pritzker School of Medicine, Chicago, Illinois, United 
      States.
FAU - Nieto, Jose
AU  - Nieto J
AD  - University of Central Florida, Department of Gastroenterology, Orlando, Florida, 
      United States.
FAU - Desai, Pankaj
AU  - Desai P
AD  - Surat Institute of Digestive Sciences, GI Endoscopy, Surat, India.
FAU - Jacques, Jeremie
AU  - Jacques J
AD  - CHU Dupytren Limoges, Service d'Hepato-gastro-enterologie, Limoges, France.
FAU - Bejjani, Michael
AU  - Bejjani M
AD  - Johns Hopkins Medicine, Gastroenterology and Hepatology, Baltimore, Maryland, 
      United States.
FAU - Pioche, Mathieu
AU  - Pioche M
AD  - Hopital Edouard Herriot, Endoscopy Unit, Digestive Disease Department, Lyon, 
      France.
FAU - Kumta, Nikhil
AU  - Kumta N
AD  - Icahn School of Medicine at Mount Sinai, Division of Gastroenterology, New York, 
      New York, United States.
FAU - Hernandez-Mondragon, Oscar
AU  - Hernandez-Mondragon O
AD  - IMSS, Digestive Endoscopy, Mexico City, Mexico.
FAU - Ujiki, Michael
AU  - Ujiki M
AD  - NorthShore University Health Systems, NorthShore Center for Simulation and 
      Innovation, Evanston, Illinois, United States.
FAU - Khashab, Mouen
AU  - Khashab M
AD  - Johns Hopkins Medicine, Gastroenterology and Hepatology, Baltimore, Maryland, 
      United States.
LA  - eng
PT  - Journal Article
DEP - 20230629
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC10310448
COIS- Competing interests Mouen A. Khashab is a consultant for Boston Scientific, 
      Olympus America, Medtronic and GI Supply. Nikhil A. Kumta is a consultant for 
      Apollo Endosurgery, Boston Scientific, Olympus, SafeHeal. Mathieu Pioche is a 
      consultant for Boston scientific, Cook medical, Olympus, Pentax, Provepharm, 
      Norgine. Jeremie Jacques is a consultant and is involved in training for Erbe, 
      Fujifilm, Boston Scientific, Olympus. Jose M. Nieto is a Consultant for Boston 
      Scientific and AbbVie Inc; honoraria from Erbe USA. Michael Ujiki is a is a 
      Scientific board member for Boston Scientific, a Consultant for Cook, a 
      Consultant for Olympus, a Consultant and speaker for WL Gore and Associates, and 
      a Speaker for Medtronic. All other authors disclose no conflicts of interest.
EDAT- 2023/07/03 13:06
MHDA- 2023/07/03 13:07
PMCR- 2023/06/01
CRDT- 2023/07/03 11:39
PHST- 2022/12/28 00:00 [received]
PHST- 2023/03/30 00:00 [accepted]
PHST- 2023/07/03 13:07 [medline]
PHST- 2023/07/03 13:06 [pubmed]
PHST- 2023/07/03 11:39 [entrez]
PHST- 2023/06/01 00:00 [pmc-release]
AID - 10.1055/a-2067-9105 [doi]
PST - epublish
SO  - Endosc Int Open. 2023 Jun 29;11(6):E607-E612. doi: 10.1055/a-2067-9105. 
      eCollection 2023 Jun.