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Peroral endoscopic myotomy for the treatment of esophageal diverticulum: an experience in China

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Abstract

Background

With the development of minimally invasive endoscopic approaches for the esophagus in recent years, peroral endoscopic myotomy (POEM) in the treatment of esophageal diverticulum has been described recently in some reports due to its successful outcomes. The aim of this study is to report our experience with the use of diverticular POEM (D-POEM) technique in the management of esophageal diverticulum.

Methods

This retrospective study included consecutive patients with symptomatic esophageal diverticulum who visited our endoscopy center between April 2014 and January 2019. D-POEM was performed based on the principles of submucosal endoscopy. A new symptomatic scoring system was introduced to evaluate the severity of diverticular symptoms.

Results

A total of 10 patients with esophageal diverticulum (Zenker’s 2, mid-esophagus 5, and epiphrenic 3) were included. The overall technical success rate of D-POEM was 100%, with a mean procedure time of 38.9 ± 20.5 (range 16–70) min. No serious complications occurred. Clinical improvement was achieved in 90% (9/10) of patients. The symptomatic score was significantly decreased from 2.5 (IQR 2.00–3.25) to 1.0 (IQR 0–1.25) (P = 0.007) during a median follow-up period of 11.0 (IQR 10.25–17.25) months.

Conclusion

These findings suggested complete septotomy by D-POEM. Our preliminary data and experience put forwarded D-POEM as a safe and effective technique for esophageal diverticulum.

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Funding

National Key R&D Program of China (Grant No. 2017YFC0112305).

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  1. Xianhui Zeng and Shuai Bai are co-first authors.

Authors and Affiliations

  1. Department of Gastroenterology, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Wuhou District, Chengdu, China

    Xianhui Zeng, Shuai Bai, Yuhang Zhang, Liansong Ye, Xianglei Yuan & Bing Hu

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Correspondence to Bing Hu.

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Xianhui Zeng, Shuai Bai, Yuhang Zhang, Liansong Ye, Xianglei Yuan, and Bing Hu have no conflicts of interest or financial ties to disclose.

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Zeng, X., Bai, S., Zhang, Y. et al. Peroral endoscopic myotomy for the treatment of esophageal diverticulum: an experience in China. Surg Endosc 35, 1990–1996 (2021). https://doi.org/10.1007/s00464-020-07593-6

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  • DOI: https://doi.org/10.1007/s00464-020-07593-6

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