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- Title
Diverticular peroral endoscopic myotomy (D-POEM) for symptomatic oesophageal diverticulum: a multicentre cohort study with a minimum follow-up of 3 years.
- Authors
Ren, Lihua; Ye, Hui; Zhu, Ye; Xie, Weihua; Liang, Yan; Liu, Yang; Dong, Jingwu; Chen, Weixu; Chen, Xinfu; Wang, Bin; Pan, Liang; Shi, Ruihua
- Abstract
Objective: To evaluate the medium- and long-term outcomes of diverticular peroral endoscopic myotomy (D-POEM) for symptomatic oesophageal diverticulum. Methods: Consecutive patients with symptomatic oesophageal diverticulum who underwent D-POEM from 1st May 2016 to 1st April 2020 in 6 centres were extracted and researched. Symptoms assessed by the modified Eckardt score were registered pre- and post-D-POEM at 1, 6, 12, 24 and 36 months. Results: A total of 34 patients with Zenker's diverticulum (ZD, n = 12), mid-oesophageal diverticulum (MED, n = 12), and epiphrenic diverticulum (ED, n = 10) were included. Complete septotomy was achieved in a mean of 39.15 min, with 100% technical success. No severe intraoperative or postoperative complications were observed. Five patients exhibited subcutaneous emphysema, while 1 had mucosal injury. The mean Eckardt score was 8.59 preoperatively and 2.56 at 1 month, 2.09 at 6 months, 2.21 at 12 months, 2.15 at 24 months, and 2.21 at 36 months postoperatively. The total clinical success rates at 1, 6, 12, 24 and 36 months postoperatively were 97.1%, 97.1%, 94.1%, 91.2%, and 88.2%, respectively. With a median follow-up of 47.2 months, four patients suffered symptom relapse, with a total clinical success rate of 88.2%. A long disease duration, a high Eckardt score, and coexistence of achalasia were identified as risk factors for symptomatic recurrence by multivariable Cox analysis. Conclusions: D-POEM is an effective and durable treatment for patients with symptomatic oesophageal diverticulum.
- Subjects
MYOTOMY; DIVERTICULUM; ESOPHAGEAL surgery
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 1, p253
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-023-10471-6