Peroral endoscopic myotomy for the treatment of esophageal diverticulum: an experience in China

Peroral endoscopic myotomy treatment for symptomatic esophageal diverticulum: a systematic review and meta-analysis

“…Across these complications, the perforation rate in three studies ranged from 5 to 25%, and the pooled total perforation rate was 6%, which was lower than that for FESD treatment. Furthermore, all patients who suffered complications of perforation included in our studies did not require open surgery because the low-flow setting of carbon dioxide (CO 2 ) was used during all procedures [4,10,18]. Therefore, even if perforation occurred, CO 2 dispersed soon, emphysema disappeared quickly, and abscesses scarcely occurred.…”

“…All studies were published between 2017 and 2020, and their enrolment periods ranged from 2014 to 2019. Two studies [18,22] had a prospective design, whereas the other seven [4,10,12,[19][20][21]23] were retrospective cohort studies. Two studies [10,21] were multicentre studies including three centres in Asia, seven in the United States, two in Europe, and one in Mexico, and others were single-centre studies.…”

“…The populations enrolled per study ranged from 4 to 75, with patient age ranging from 43 to 90 years. Seven studies [4,10,18,19,[21][22][23] provided information about whether the included population underwent prior medical interventions. Of these, 25 (25/138, 18.1%) patients had received previous medical treatments.…”

“…Fulfilment of the inclusion and exclusion criteria was assessed for the above 14 studies. Of these, nine articles matched the selection criteria and were finally included in the meta-analysis [4,10,12,[18][19][20][21][22][23].…”

“…Its pathophysiology is not completely understood and is widely considered to be associated with increased intraluminal pressure secondary to motor abnormalities or the weakening of the esophageal mucosal membrane [3]. Based on the location and characteristic pathophysiology, esophageal diverticula are classified into three types: Zenker's diverticula, mid-esophageal diverticula, and epiphrenic diverticula [4].…”