Background: Killian-Jamieson diverticulum (KJD) is a rare type of esophageal diverticulum that occurs in a specific area called the Killian-Jamieson space. While surgery has been the conventional treatment for symptomatic KJD, minimally invasive endoscopic techniques, particularly Killian-Jamieson per-oral endoscopic myotomy (KJ-POEM), have emerged as an alternative. The aim of the study is to evaluate the effectiveness and safety of KJ-POEM in treating KJD.
Methods: This is an international, multicenter, retrospective study that included patients who underwent KJ-POEM for symptomatic KJD during the period between 10/16/2018 and 4/12/2023. The primary outcome was clinical success, defined as a complete or near-complete resolution of symptoms (i.e., a post-procedure Kothari-Haber Score ≤ 2). Secondary outcomes were technical success (defined as successful completion of all procedural steps), rate and severity of adverse events, total procedure duration, and symptom recurrence during follow-up.
Results: A total of 13 patients (mean age 65.23 years, 6 are female) with KJD, and a mean pre-procedure Kothari-Haber Score of 6 (SD 2.16), underwent KJ-POEM across 10 participating centers. Clinical success and technical success were achieved in all cases (100%) with a mean post-procedure Kothari-Haber Score of 0.91 (SD 0.99). There were no adverse events and no cases of injury to the recurrent laryngeal nerve. The mean length of the hospital stay was 1.09 (SD 0.74) days. Mean follow up time was 9.41SD (10.07) months post-procedure. There was no post-procedure symptom recurrence in all patients.
Conclusion: KJ-POEM is a safe and effective alternative treatment option for symptomatic KJD with excellent short/mid-term outcomes.