Per-oral endoscopic myotomy with septotomy for the treatment of distal esophageal diverticula (D-POEM).

Surgical Endoscopy
Paul BasileMarc Barthet

Abstract

Epinephric diverticula are frequently associated with esophageal motility disorder. Their management implies surgery, with 15% morbidity and 3% mortality rates. Flexible endoscopy could be an effective and safer approach for treating esophageal diverticulum with motility disorder. We report our experience of seven consecutive cases treated with per-oral endoscopic submucosal septotomy and myotomy (D-POEM). Seven consecutive patients were referred for symptomatic non-zenker's esophageal diverticulum. The steps of the procedure were as follows: (i) analysis of the esophageal anatomy; (ii) vertical mucosal incision just above the upper edge of the diverticulum; (iii) submucosal tunneling by submucosal dissection, alongside the submucosal window of the diverticulum and the downstream septum; (iv) identification of the septum and the diverticular area; (v) diverticular septotomy followed by antegrade esocardial myotomy up to 2 cm below the cardia; and (vi) closure of the mucosal incision. Three men and four women aged from 62 to 90 years were treated. Four patients had a diet with adapted texture before the treatment and five patients had weight loss (4 kg to 24 kg). At preoperative evaluation, all had an esophageal motility disorde...Continue Reading

References

May 5, 2011·World Journal of Surgery·Giovanni ZaninottoAlberto Ruol
Jan 22, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·David S Y ChanGuy R J C Blackshaw
Aug 6, 2017·American Journal of Surgery·Alison E BrandeisSumeet K Mittal
Nov 15, 2017·Endoscopy·Antônio Carlos ConradoDiego Laurentino Lima
Jan 10, 2019·VideoGIE : an Official Video Journal of the American Society for Gastrointestinal Endoscopy·Zaheer NabiD Nageshwar Reddy

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Citations

Nov 27, 2020·Clinical Endoscopy·Bogdan P MiutescuMouen A Khashab
Apr 22, 2021·Esophagus : Official Journal of the Japan Esophageal Society·Harshal S MandavdhareUsha Dutta
Mar 13, 2021·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Harshal S MandavdhareUsha Dutta

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