Digestive diseases (Basel, Switzerland) · 2025
Zenker Peroral Endoscopic Myotomy Is Safe and Effective for the Management of Pharyngeal Pouch: A Multicentre Retrospective Cohort Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Norton Benjamin, Siggens Katie, Papaefthymiou Apostolis, Telese Andrea, Duku Margaret, Murino Alberto, Johnson Gavin, Murray Charles, Mohammadi Borzoueh, Mughal Muntzer, Bisschops Raf, Mohammed Noor, Bhandari Pradeep, Birchall Martin, Haidry Rehan
Аннотация
UNLABELLED: <p>Introduction: A Zenker diverticulum (ZD) is a sac-like outpouching at the pharyngo-oesophageal junction, which is characterised by dysphagia and regurgitation. Surgery has been the predominant treatment but carries the burden of invasiveness, complications, and recurrence. Zenker peroral endoscopic myotomy (Z-POEM) is an alternative minimally invasive endoscopic treatment for ZD. We report on the safety and efficacy of Z-POEM in the UK.
METHODS: Consecutive patients undergoing Z-POEM by expert interventional endoscopists at four UK referral centres were retrospectively analysed between 2019 and 2024. Patient demographics, technical and clinical success, and 30-day adverse events were recorded. The primary outcome was clinical success, which was defined as a reduction in Dakkak and Bennett dysphagia score to ≤1 without need for repeat intervention.
RESULTS: Among 61 patients undergoing Z-POEM, the median age was 76 (IQR 69-80), 37.7% (n = 23) were female, mean pouch size was 37.3 mm (SD 18.0) in depth, and 37.3% had undergone prior intervention. The overall technical success was 100%, mean procedural time was 49.4 min (SD 19.3), and 10 patients underwent a hybrid procedure due to submucosal fibrosis. Overall, the clinical success was 93.1% over a mean follow-up of 11.2 months. There were five AEs related to the procedure classified as AGREE grade II (8.5%), and the recurrence rate was 11.1% over a median time of 7.5 months (IQR 6.3-10.3).
CONCLUSION: Z-POEM is a safe and effective endoscopic treatment for ZD that is associated with high technical and clinical success. A hybrid procedure may be utilised in the presence of submucosal fibrosis. </p>.
METHODS: Consecutive patients undergoing Z-POEM by expert interventional endoscopists at four UK referral centres were retrospectively analysed between 2019 and 2024. Patient demographics, technical and clinical success, and 30-day adverse events were recorded. The primary outcome was clinical success, which was defined as a reduction in Dakkak and Bennett dysphagia score to ≤1 without need for repeat intervention.
RESULTS: Among 61 patients undergoing Z-POEM, the median age was 76 (IQR 69-80), 37.7% (n = 23) were female, mean pouch size was 37.3 mm (SD 18.0) in depth, and 37.3% had undergone prior intervention. The overall technical success was 100%, mean procedural time was 49.4 min (SD 19.3), and 10 patients underwent a hybrid procedure due to submucosal fibrosis. Overall, the clinical success was 93.1% over a mean follow-up of 11.2 months. There were five AEs related to the procedure classified as AGREE grade II (8.5%), and the recurrence rate was 11.1% over a median time of 7.5 months (IQR 6.3-10.3).
CONCLUSION: Z-POEM is a safe and effective endoscopic treatment for ZD that is associated with high technical and clinical success. A hybrid procedure may be utilised in the presence of submucosal fibrosis. </p>.