Gastroenterology Division, Internal Medicine Department, Faculty of Medicine, Cairo University, Kasr Alainy Street Cairo, Cairo, 11311, Egypt.
Gastroenterology Department, Manuel Gea Gonzalez General Hospital, Mexico City, Mexico.
Esophagus. 2021 Jul;18(3):693-699. doi: 10.1007/s10388-020-00809-7. Epub 2021 Jan 2.
Peroral endoscopic myotomy for the treatment of Zenker's diverticulum (Z-POEM) is a novel technique that has been described in several recent reports. This method utilizes the third space (submucosal layer) to create a tunnel to facilitate complete visualization of the septum and hence cutting it entirely. Conventional endoscopic septotomy carries the risk of recurrence due to incomplete visualization of the septum. While surgical correction is a risky and lengthy procedure in old comorbid patients with Zenker's diverticulum. The aim of this study is to assess the efficacy and safety of Z-POEM.
The study enrolled 24 patients diagnosed with Zenker's diverticulum (ZD) who underwent Z-POEM at seven independent endoscopy centers in five different countries.
Mean patient age ± standard deviation (SD) was 74.3 ± 11 years. Most of the patients were males (n = 20, 83.3%); four (16.7%) were females. More than 50% of the patients (n = 14, 58.3%) had associated comorbidities. The mean size of the diverticula was 4 cm (range 2-7 cm). The Kothari-Haber Score was used to assess clinical symptoms; values ranged from 6 to 14 (median = 9). We achieved 100% technical success with a median procedure time of 61 min and no adverse events. Median hospital stay was 1 day (range 1-5 days). There is a significant reduction in the Kothari-Haber Score after Z-POEM (P < 0.0001). Technical success was achieved in 100% of the patients. Clinical success was achieved in 23/24 (95.8%) of the patients with a median follow-up of 10 months (range 6-24 months).
Z-POEM is a safe and effective modality for managing ZD.
经口内镜肌切开术（Z-POEM）治疗Zenker 憩室（Z-POEM）是一种新的技术，已经在最近的几个报道中被描述。这种方法利用第三空间（黏膜下层）创建一个隧道，以促进完全可视化的间隔，因此完全切割。传统的内镜隔切开术由于间隔的不完全可视化而存在复发的风险。虽然对于患有Zenker 憩室的老年合并症患者，手术矫正风险高且过程漫长。本研究旨在评估 Z-POEM 的疗效和安全性。
这项研究共纳入了 24 名被诊断为 Zenker 憩室（ZD）的患者，他们在五个不同国家的七个独立内镜中心接受了 Z-POEM。
患者平均年龄为 74.3±11 岁。大多数患者为男性（n=20，83.3%）；4 名（16.7%）为女性。超过 50%的患者（n=14，58.3%）有合并症。憩室的平均大小为 4cm（范围 2-7cm）。Kothari-Haber 评分用于评估临床症状；值范围从 6 到 14（中位数=9）。我们通过经口内镜肌切开术达到了 100%的技术成功率，中位手术时间为 61 分钟，无不良事件。中位住院时间为 1 天（范围 1-5 天）。经口内镜肌切开术后，Kothari-Haber 评分显著降低（P<0.0001）。100%的患者达到了技术上的成功。24 例患者中有 23 例（95.8%）达到了临床成功，中位随访时间为 10 个月（范围 6-24 个月）。
Z-POEM 是治疗 ZD 的一种安全有效的方法。
