Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in India
Background This study was aimed to evaluate efficacy and safety of Z–peroral endoscopic myotomy (Z-POEM; submucosal tunneling endoscopic myotomy) for Zenker’s diverticulum (ZD). Methods This is a retrospective study at a single tertiary care center in India. The Z-POEM technique was performed using...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2020-09-01
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| Series: | Journal of Digestive Endoscopy |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1716584 |
| _version_ | 1811288515817766912 |
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| author | Pankaj N. Desai Mayank V. Kabrawala Chintan N. Patel Rajiv M. Mehta Subhash K. Nandwani Ritesh Prajapati Nisharg Patel Krishna K. Parekh |
| author_facet | Pankaj N. Desai Mayank V. Kabrawala Chintan N. Patel Rajiv M. Mehta Subhash K. Nandwani Ritesh Prajapati Nisharg Patel Krishna K. Parekh |
| author_sort | Pankaj N. Desai |
| collection | DOAJ |
| description | Background This study was aimed to evaluate efficacy and safety of Z–peroral endoscopic myotomy (Z-POEM; submucosal tunneling endoscopic myotomy) for Zenker’s diverticulum (ZD).
Methods This is a retrospective study at a single tertiary care center in India. The Z-POEM technique was performed using principles of submucosal tunneling endoscopy with prior experience from POEM technique for achalasia cardia
Results Sixteen patients (male, 62.5%; mean age, 73.2 ± 5.2 years) were included with a mean Charleson’s comorbidity index of 4.32. The mean size of ZD was 34.8 ± 10.0 mm. The technical success rate was 100%. Clinical success was achieved in 100% (16/16) with a decrease in mean dysphagia score from 2.9 to 0.2 (p <0.0001). The mean procedure time was 47 ± 7.9 minutes and mean length of septotomy was 31.9 ± 9.4 mm. The mean length of hospital stay was 1.2 ± 0.4 days. No major adverse events were noted. Capnomediastinum was noted in two cases on follow-up Gastrografin study after 24 hours (12.5%). This did not merit any treatment. One patient had intraprocedural bleed which was controlled easily. At the 18-month follow-up, two (12.5%) patients reported dysphagia recurrence (Dakkak and Bennett score 1) but did not require repeat intervention.
Conclusion Endoscopic management of ZD using the POEM technique is a promising technique with improved efficacy and safety. However, long-term follow-up is needed to ensure the durability of response. |
| first_indexed | 2024-04-13T03:38:26Z |
| format | Article |
| id | doaj.art-c7cae2b1e88547ed854a19b87ec836bb |
| institution | Directory Open Access Journal |
| issn | 0976-5042 0976-5050 |
| language | English |
| last_indexed | 2024-04-13T03:38:26Z |
| publishDate | 2020-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Digestive Endoscopy |
| spelling | doaj.art-c7cae2b1e88547ed854a19b87ec836bb2022-12-22T03:04:15ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Digestive Endoscopy0976-50420976-50502020-09-01110320921410.1055/s-0040-1716584Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in IndiaPankaj N. Desai0Mayank V. Kabrawala1Chintan N. Patel2Rajiv M. Mehta3Subhash K. Nandwani4Ritesh Prajapati5Nisharg Patel6Krishna K. Parekh7Department of Endoscopy and Endosonography, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, IndiaDepartment of Endoscopy and Endosonography, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, IndiaDepartment of Endoscopy and Endosonography, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, IndiaDepartment of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, IndiaDepartment of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, IndiaDepartment of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, IndiaDepartment of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, IndiaDepartment of Clinical Research, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, IndiaBackground This study was aimed to evaluate efficacy and safety of Z–peroral endoscopic myotomy (Z-POEM; submucosal tunneling endoscopic myotomy) for Zenker’s diverticulum (ZD). Methods This is a retrospective study at a single tertiary care center in India. The Z-POEM technique was performed using principles of submucosal tunneling endoscopy with prior experience from POEM technique for achalasia cardia Results Sixteen patients (male, 62.5%; mean age, 73.2 ± 5.2 years) were included with a mean Charleson’s comorbidity index of 4.32. The mean size of ZD was 34.8 ± 10.0 mm. The technical success rate was 100%. Clinical success was achieved in 100% (16/16) with a decrease in mean dysphagia score from 2.9 to 0.2 (p <0.0001). The mean procedure time was 47 ± 7.9 minutes and mean length of septotomy was 31.9 ± 9.4 mm. The mean length of hospital stay was 1.2 ± 0.4 days. No major adverse events were noted. Capnomediastinum was noted in two cases on follow-up Gastrografin study after 24 hours (12.5%). This did not merit any treatment. One patient had intraprocedural bleed which was controlled easily. At the 18-month follow-up, two (12.5%) patients reported dysphagia recurrence (Dakkak and Bennett score 1) but did not require repeat intervention. Conclusion Endoscopic management of ZD using the POEM technique is a promising technique with improved efficacy and safety. However, long-term follow-up is needed to ensure the durability of response.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1716584septotomysubmucosal tunneling endoscopyzenker’s diverticulumz-poem |
| spellingShingle | Pankaj N. Desai Mayank V. Kabrawala Chintan N. Patel Rajiv M. Mehta Subhash K. Nandwani Ritesh Prajapati Nisharg Patel Krishna K. Parekh Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in India Journal of Digestive Endoscopy septotomy submucosal tunneling endoscopy zenker’s diverticulum z-poem |
| title | Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in India |
| title_full | Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in India |
| title_fullStr | Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in India |
| title_full_unstemmed | Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in India |
| title_short | Z-POEM as a Treatment Option for Zenker’s Diverticulum: Our Experience at a Tertiary Care Centre in India |
| title_sort | z poem as a treatment option for zenker s diverticulum our experience at a tertiary care centre in india |
| topic | septotomy submucosal tunneling endoscopy zenker’s diverticulum z-poem |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1716584 |
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