Peroral endoscopic myotomy succeeds in treatment of oesophageal diverticula

Treatment with peroral endoscopic myotomy (POEM) appears safe and effective in patients with oesophageal diverticula, reports a recent study.

A meta-analysis was conducted to assess the efficacy and safety profile of POEM in patients with Zenker (ZD) and epiphrenic diverticula. The investigators performed a literature search through August 2020 and identified 12 studies that assessed POEM in a total of 300 patients.

Treatment success was the primary outcome, and results were articulated as pooled rates with 95 percent confidence intervals (CIs).

Technical success showed a pooled rate of 95.9 percent (95 percent CI, 93.4‒98.3) in patients with ZD and 95.1 percent (95 percent CI, 88.8‒100) in those with epiphrenic diverticula. The pooled rate for treatment success was similar for ZD (90.6 percent, 95 percent CI, 87.1‒94.1) and epiphrenic diverticula (94.2 percent, 95 percent CI, 87.3‒100).

In ZD patients, treatment success rates persisted at 1 year (90 percent, 95 percent CI, 86.4‒97.4) and 2 years (89.6 percent, 95 percent CI, 82.2‒96.9).

For symptom recurrence, the pooled rate was 2.6 percent (95 percent CI, 0.9‒4.4) in ZD patients and 0 percent in those with epiphrenic diverticula. The pooled rates for adverse events (AEs) and severe AEs were 10.6 percent (95 percent CI, 4.6‒16.6) and 3.5 percent (95 percent CI, 0‒7.4) in ZD and 8.4 percent (95 percent CI, 0‒16.8) and 8.4 percent (95 percent CI, 0‒16.8) in epiphrenic diverticula.