An international study on the use of peroral endoscopic myotomy (POEM) in the management of esophageal diverticula: the first multicenter D-POEM experience

Juliana Yang; Xianhui Zeng; Xianglei Yuan; Kenneth Chang; Omid Sanaei; Lea Fayad; Vivek Kumbhari; Vikesh Singh; Anthony N. Kalloo; Bing Hu; Mouen A. Khashab

doi:10.1055/a-0759-1428

Endoscopy, Table of Contents

Endoscopy 2019; 51(04): 346-349
DOI: 10.1055/a-0759-1428

Innovations and brief communications

An international study on the use of peroral endoscopic myotomy (POEM) in the management of esophageal diverticula: the first multicenter D-POEM experience

Juliana Yang

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

,

Xianhui Zeng

²Division of Gastroenterology and Hepatology, West China Medical Center of Sichuan University, Chengdu, Sichuan, China

,

Xianglei Yuan

²Division of Gastroenterology and Hepatology, West China Medical Center of Sichuan University, Chengdu, Sichuan, China

,

Kenneth Chang

³Division of Gastroenterology, University of California Irvine, Irvine, California, USA

,

Omid Sanaei

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

,

Lea Fayad

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

,

Vivek Kumbhari

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

,

Vikesh Singh

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

,

Anthony N. Kalloo

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

,

Bing Hu

²Division of Gastroenterology and Hepatology, West China Medical Center of Sichuan University, Chengdu, Sichuan, China

,

Mouen A. Khashab

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

› Author Affiliations

Abstract

Background The aim of this study is to report a novel, multicenter experience with the diverticular peroral endoscopic myotomy (D-POEM) technique in the management of esophageal diverticula.

Methods This is a multicenter, international, retrospective study involving three centers. D-POEM was performed using the principles of submucosal endoscopy.

Results A total of 11 patients with an esophageal diverticulum (Zenker’s 7, mid-esophagus 1, epiphrenic 3) were included. The mean size of the esophageal diverticula was 34.5 mm. The overall technical success rate of D-POEM was 90.9 %, with a mean procedure time of 63.2 minutes. There were no adverse events. Clinical success was achieved in 100 % (10 /10), with a decrease in mean dysphagia score from 2.7 to 0.1 (P < 0.001) during a median follow-up of 145 days (interquartile range 126 – 273).

Conclusion Endoscopic management of esophageal diverticula using the novel technique of D-POEM appears promising. This first case series on D-POEM suggests that the procedure is feasible, safe, and effective in the management of esophageal diverticula. D-POEM offers the distinct advantage of ensuring a complete septotomy. Larger studies are needed to confirm these intriguing results.

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References

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