Zenker Peroral Endoscopic Myotomy Is Safe and Effective for the Management of Pharyngeal Pouch: A Multicentre Retrospective Cohort Study.
No Thumbnail Available
All Authors
Norton, B.
Siggens, K.
Papaefthymiou, A.
Telese, A.
Duku, M.
Murino, A.
Johnson, G.
Murray, C.
Mohammadi, B.
Mughal, M.
LTHT Author
Mohammed, Noor
LTHT Department
Abdominal Medicine & Surgery
Gastroenterology
Gastroenterology
Non Medic
Publication Date
2025
Item Type
Journal Article
Multicenter Study
Multicenter Study
Language
Subject
Subject Headings
Abstract
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. .
Journal
Digestive Diseases