Peroral endoscopic myotomy (POEM) for esophageal diverticula

Samanta, Jayanta; Nabi, Zaheer; Dhar, Jahnvi; Mandavdhare, Harshal

doi:10.23736/s2724-5985.21.02984-3

Cited by 5 publications

(4 citation statements)

References 37 publications

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“… 53 , 54 There are no data comparing the two approaches; therefore, it may be prudent to individualize the management approach in these cases. In a recent review, Samanta et al 55 proposed a tailored approach to EED based on the size of the diverticulum and the presence or absence of esophageal motility disorder with a non-relaxing lower esophageal sphincter. The authors suggested that septotomy may be avoided in cases with small diverticula and non-relaxing lower esophageal sphincter.…”

Section: Current Spectrum Of Submucosal Endoscopymentioning

confidence: 99%

Submucosal endoscopy: the present and future

Nabi

Reddy

2023

Clin Endosc

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Submucosal endoscopy or third-space endoscopy utilizes the potential space between the mucosal and muscularis layers of the gastrointestinal tract to execute therapeutic interventions for various diseases. Over the last decade, endoscopic access to the submucosal space has revolutionized the field of therapeutic endoscopy. Submucosal endoscopy was originally used to perform endoscopic myotomy in patients with achalasia cardia, and its use has grown exponentially since. Currently, submucosal endoscopy is widely used to resect subepithelial tumors and to manage refractory gastroparesis and Zenker's diverticulum. While the utility of submucosal endoscopy has stood the test of time in esophageal motility disorders and subepithelial tumors, its durability remains to be established in conditions such as Zenker's diverticulum and refractory gastroparesis. Other emerging indications for submucosal endoscopy include esophageal epiphrenic diverticulum, Hirschsprung's disease, and esophageal strictures not amenable to conventional endoscopic treatment. The potential of submucosal endoscopy to provide easy and safe access to the mediastinum and peritoneal spaces may open doors to novel indications and rejuvenate the interest of endoscopists in natural orifice transluminal endoscopic surgery in the future. This review focuses on the current spectrum, recent updates, and future direction of submucosal endoscopy in the gastrointestinal tract.

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Section: Current Spectrum Of Submucosal Endoscopymentioning

confidence: 99%

Submucosal endoscopy: the present and future

Nabi

Reddy

2023

Clin Endosc

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“…The POEM principles have also been proposed as a treatment for non-Zenker esophageal diverticula. Surgery, even in minimally invasive variants such as thoracoscopy or laparoscopy, is associated with high morbidity (8%-23% risk of leaks or fistulas) and mortality (0%-7%) (18), which justifies the growing interest in using thirdspace endoscopy procedures. Most studies have evaluated the outcomes of diverticular POEM (D-POEM) for epiphrenic diverticula (EPD) (11,19), although case reports treating mid-esophageal (20) and Killian-Jamieson diverticula have also been published (21).…”

Section: D-poemmentioning

confidence: 99%

“…EPD are categorized as "pulsion diverticula" based on their pathophysiology, or as "pseudodiverticula" or "false diverticula" since they lack muscular layer. In 75%-80% of the cases, they are associated with an EMD (18). Hence, an adequate preoperative study including endoscopy, high-resolution manometry (HRM) and barium study is essential to size the diverticulum and tailor the length of the myotomy.…”

Section: D-poemmentioning

confidence: 99%

POEM from A to Z: current perspectives

Albéniz¹,

Valenciano²,

Estremera-Arévalo³

et al. 2023

Rev Esp Enferm Dig

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“…Therefore, comparative studies with adequate follow-up duration are required in the future. In a recent review, Samanta et al proposed a personalized approach to EED ( 43 ). The authors suggested that POEM alone may be sufficient in cases with small EED and coexistent esophageal motility disorders.…”

Section: Technique Of D-peroral Endoscopic Myotomy: Septotomy Vs No S...mentioning

confidence: 99%

Impact of modified techniques on outcomes of peroral endoscopic myotomy: A narrative review

Nabi

Reddy

2022

Front. Med.

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Peroral endoscopic myotomy (POEM) is an established frontline treatment modality for achalasia cardia. Since its initial description, several modifications have been proposed to the technique of POEM. Broadly speaking, these modifications follow the basic principles of submucosal endoscopy, but incorporate variations in the POEM technique, including the difference in the orientation of myotomy (anterior or posterior), length of myotomy (short or long), and thickness of myotomy (selective circular or full thickness). Some of these modifications have been shown to reduce procedural duration without compromising the efficacy of the POEM procedure. More recently, several alterations have been reported that intend to reduce gastroesophageal reflux after POEM. These include preservation of sling fibers during posterior POEM and addition of NOTES fundoplication to the POEM procedure. Although some of the modified techniques have been compared with the conventional techniques in quality trials, randomized studies are awaited for others. The incorporation of some of these modifications will likely make POEM a technically easy and safer modality in near future. This review aims to discuss the current evidence with regard to the impact of modified techniques on the outcome of POEM.

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Peroral endoscopic myotomy (POEM) for esophageal diverticula

Cited by 5 publications

References 37 publications

Submucosal endoscopy: the present and future

Submucosal endoscopy: the present and future

POEM from A to Z: current perspectives

Impact of modified techniques on outcomes of peroral endoscopic myotomy: A narrative review

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