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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(10): E1214-E1219
DOI: 10.1055/a-2399-7464
Original article

Peroral endoscopic myotomy as a treatment for Killian–Jamieson diverticulum (KJ-POEM)

Redeat Libanos Assefa
1   Gastroenterology, Johns Hopkins University, Baltimore, United States (Ringgold ID: RIN1466)
,
Michael Bejjani
2   Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, United States (Ringgold ID: RIN1501)
,
Amit Mehta
3   Gastroenterology, Johns Hopkins, Baltimore, United States (Ringgold ID: RIN1466)
,
Apurva Shrigiriwar
4   Medicine, Gastroenterology, Johns Hopkins Medicine, Baltimore, United States (Ringgold ID: RIN1501)
,
Farimah Fayyaz
1   Gastroenterology, Johns Hopkins University, Baltimore, United States (Ringgold ID: RIN1466)
,
Yuto Shimamura 
5   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Haruhiro Inoue
5   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Francesco Vito Mandarino 
6   Division of Gastroenterology and Gastrointestinal Endoscopy, Department of Experimental Oncology, Università Vita-Salute San Raffaele Facoltà di Medicina e Chirurgia, Milano, Italy (Ringgold ID: RIN478583)
,
Francesco Azzolini
7   Gastroenterology and Gastrointestinal Endoscopy, Università Vita-Salute San Raffaele, IRCCS San Raffael Hospital, Milan, Italy
,
Steven P Bowers
8   Surgery, Mayo Clinic, Jacksonville, United States
,
Zhen Li
8   Surgery, Mayo Clinic, Jacksonville, United States
,
Carlos Robles-Medranda
9   Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas, Torree, Ecuador
,
Martha Arevalo
9   Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas, Torree, Ecuador
,
Vinay Dhir
10   Dept of Therapeutic Endoscopy and Endosonography, Institute of Advanced Endoscopy, Mumbai, India
,
Gianluca Andrisani
11   Digestive Endoscopy Unit, Catholic University, Rome, Italy
,
Alina Tantau
12   4th Medical Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
,
Michael Lajin 
13   Gastroenterology/internal med, Sharp Grossmont Hospital, La Mesa, California, United States (Ringgold ID: RIN21378)
,
Kartik Sampath
14   Gastroenterology and Hepatology, Cornell University Joan and Sanford I Weill Medical College, New York, United States (Ringgold ID: RIN12295)
,
Mouen A. Khashab
15   Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, United States
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Abstract

Background and study aims 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.

Patients and methods 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.

Results 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.

Conclusions KJ-POEM is a safe and effective alternative treatment for symptomatic KJD with excellent short/mid-term outcomes.

Keywords

Endoscopy Upper GI Tract


Publikationsverlauf

Eingereicht: 24. Januar 2024

Angenommen nach Revision: 21. August 2024

Accepted Manuscript online:
18. September 2024

Artikel online veröffentlicht:
28. Oktober 2024

© 2024. 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/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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