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Open Zenker's peroral endoscopic myotomy: technical and clinical outcomes of a novel technique (with videos)

  • 0Johns Hopkins Medicine, Baltimore, Maryland, USA.
Gastrointestinal Endoscopy +

|

March 2, 2025

|

March 2, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Open Zenker's peroral endoscopic myotomy (OZ-POEM) offers a safe and effective treatment for Zenker's diverticulum, eliminating the need for mucosal closure and showing a low recurrence rate.

Area Of Science

  • Gastroenterology
  • Surgical Innovation
  • Endoscopic Procedures

Background

  • Zenker's peroral endoscopic myotomy (Z-POEM) is effective but can face challenges with remnant mucosal flaps and closure.
  • A modified approach, Open Z-POEM (OZ-POEM), is introduced to address these limitations.

Purpose Of The Study

  • To evaluate the clinical success, safety, and feasibility of the novel Open Z-POEM (OZ-POEM) procedure.
  • To assess the impact of OZ-POEM on symptom recurrence and adverse events in patients with Zenker's diverticulum.

Main Methods

  • A retrospective observational study of 53 patients with Zenker's diverticulum who underwent OZ-POEM.
  • Outcomes assessed included clinical success (Kothari-Haber score <3), technical success, recurrence rates, and adverse events.

Main Results

  • OZ-POEM achieved 100% technical success with a mean procedure time of 19 minutes.
  • Significant symptom improvement was observed (median Kothari-Haber score decreased from 7 to 1).
  • Low rates of moderate (1.9%) and severe (1.9%) adverse events were reported, with a recurrence rate of 3.8%.

Conclusions

  • Open Z-POEM (OZ-POEM) is a feasible, safe, and efficient endoscopic procedure for Zenker's diverticulum.
  • The technique, involving extensive mucosotomy without closure, appears to contribute to a low recurrence rate.
  • Further prospective comparative studies are warranted to validate these findings.

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