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The A to Z of Peroral Endoscopic Myotomy.
J Clin Gastroenterol
February 2025
Digestive Disease and Surgery Institute, Cleveland Clinic London, UK.
Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incision. POEM was first developed for the management of achalasia, and now a decade of evidence shows the procedure is safe, effective, and highly reproducible.
View Article and Find Full Text PDFZenker per-oral endoscopic myotomy (Z-POEM): The ideal first-line therapy for treatment of Zenker diverticulum.
J Thorac Cardiovasc Surg
December 2024
Section of Thoracic Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba Research Institute, Winnipeg, Manitoba, Canada; Department of Physiology & Pathophysiology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Biomedical Engineering, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address:
Objective: Zenker diverticulum is a mucosal herniation at the pharyngoesophageal junction. Although open surgical myotomy is the conventional treatment, robust evidence on third-space flexible endoscopic myotomy is lacking. We assessed safety, effectiveness, and patient-reported outcomes of per-oral endoscopic myotomy (Z-POEM) in the largest reported single-center experience with this technique.
View Article and Find Full Text PDFEndoscopic Submucosal Tunneling Techniques versus Flexible Endoscopic Septotomy for Zenker's Diverticulum: A Systematic Review and Meta-Analysis.
Gastrointest Endosc
November 2024
Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Endoscopy Unit, Alfa Institute of Gastroenterology, Belo Horizonte, Brazil; Hospital Mater Dei Contorno, Belo Horizonte, Brazil.
Background And Aims: Zenker's diverticulum (ZD) is the most common type of esophageal diverticulum. We conducted a systematic review and meta-analysis aiming to compare the effectiveness and safety of endoscopic submucosal tunneling techniques (ESTT) and flexible endoscopic septotomy (FES) for treating patients with ZD, including subgroup analyses by follow-up duration (<12 months and ≥12 months), diverticulum size (<2.5cm and ≥2.
View Article and Find Full Text PDFAdvances in Third Space Endoscopy.
Gastroenterol Clin North Am
December 2024
Division of Gastroenterology and Hepatology, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA. Electronic address:
Article Synopsis
- * It discusses peroral endoscopic myotomy (POEM) as a primary treatment for achalasia and compares its outcomes with other treatment options.
- * The article also covers various other TSE procedures, including G-POEM, Z-POEM, D-POEM, and STER/POET, providing insights for endoscopists looking to improve their knowledge and techniques.
Short-term clinical and technical outcomes of a modified Zenker's peroral endoscopic myotomy with mucosal flap incision.
Endoscopy
December 2024
Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, United States.
Article Synopsis
- Zenker's diverticulum peroral endoscopic myotomy (Z-POEM) with mucosal flap incision (MFI) shows high effectiveness for treating symptomatic Zenker's diverticulum, as reported in a study involving 36 patients across eight international centers.
- Clinical success was achieved in 97% of patients, with significant improvement in symptoms measured by the Kothari-Haber symptom score (KHSS).
- The procedure demonstrated a strong technical success rate, with only one minor adverse event, indicating it is a safe option for patients with this condition, although further prospective evaluations are necessary for larger diverticulums.
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