Assefa Redeat Libanos, Bejjani Michael, Mehta Amit, Shrigiriwar Apurva, Fayyaz Farimah, Shimamura Yuto, Inoue Haruhiro, Mandarino Francesco Vito, Azzolini Francesco, Bowers Steven P, Li Zhen, Robles-Medranda Carlos, Arevalo Martha, Dhir Vinay, Andrisani Gianluca, Tantau Alina, Lajin Michael, Sampath Kartik, Khashab Mouen A
Gastroenterology, Johns Hopkins University, Baltimore, United States.
Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, United States.
Endosc Int Open. 2024 Oct 28;12(10):E1214-E1219. doi: 10.1055/a-2399-7464. eCollection 2024 Oct.
Killian-Jamieson diverticulum (KJD) is a rare type of esophageal diverticulum that occurs in a specific area called the Killian-Jamieson space. Although surgery has been the conventional treatment for symptomatic KJD, minimally invasive endoscopic techniques, particularly Killian-Jamieson per-oral endoscopic myotomy (KJ-POEM), have emerged as an alternative. The aim of the study was to evaluate the effectiveness and safety of KJ-POEM in treating KJD. This was an international, multicenter, retrospective study that included patients who underwent KJ-POEM for symptomatic KJD from October 16, 2018 to April 12,2023. The primary outcome was clinical success, defined as complete or near-complete resolution of symptoms (i.e., post-procedure Kothari-Haber Score ≤ 2). Secondary outcomes were technical success (defined as successful completion of all procedural steps), rate and severity of adverse events (AEs), total procedure duration, and symptom recurrence during follow-up. A total of 13 patients (mean age 65.23 years, 6 female) with KJD and a mean pre-procedure Kothari-Haber Score of 6 (standard deviation [SD] 2.16) underwent KJ-POEM across 10 participating centers. Clinical success and technical success were achieved in all cases (100%) with a mean post-procedure Kothari-Haber Score of 0.91 (SD 0.99). There were no AEs and no cases of injury to the recurrent laryngeal nerve. Mean length of hospital stay was 1.09 days (SD 0.74). Mean follow-up time was 9.41 months (SD 10.07) post-procedure. There was no post-procedure symptom recurrence any patient. KJ-POEM is a safe and effective alternative treatment for symptomatic KJD with excellent short/mid-term outcomes.
基利安-贾米森憩室（KJD）是一种罕见的食管憩室类型，发生在一个特定区域，即基利安-贾米森间隙。虽然手术一直是有症状KJD的传统治疗方法，但微创内镜技术，特别是基利安-贾米森经口内镜下肌切开术（KJ-POEM），已成为一种替代方法。本研究的目的是评估KJ-POEM治疗KJD的有效性和安全性。这是一项国际多中心回顾性研究，纳入了2018年10月16日至2023年4月12日因有症状KJD接受KJ-POEM治疗的患者。主要结局是临床成功，定义为症状完全或接近完全缓解（即术后科塔里-哈伯评分≤2）。次要结局包括技术成功（定义为所有手术步骤成功完成）、不良事件（AE）的发生率和严重程度、总手术持续时间以及随访期间症状复发情况。共有13例KJD患者（平均年龄65.23岁，6例女性）在10个参与中心接受了KJ-POEM治疗，术前科塔里-哈伯评分平均为6分（标准差[SD]2.16）。所有病例（100%）均实现了临床成功和技术成功，术后科塔里-哈伯评分平均为0.91（SD 0.99）。未发生AE，也没有喉返神经损伤病例。平均住院时间为1.09天（SD 0.74）。术后平均随访时间为9.41个月（SD 10.07）。所有患者术后均未出现症状复发。KJ-POEM是一种安全有效的有症状KJD替代治疗方法，具有出色的短期/中期疗效。
