Peroral endoscopic myotomy treatment for symptomatic esophageal diverticulum: a systematic review and meta-analysis. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Ren, Lihua; Xie, Weihua; Mulmi Shrestha, Sachin; Ji, Qinghua; Xie, Ting; Lu, Xuejia; Dong, Jingwu; Shi, Ruihua
• Is Part Of: European journal of gastroenterology & hepatology. Volume 34:Issue 2(2022)
• Publication Date: 2022-02
• Subjects: esophageal diverticulum -- meta-analysis -- motility disorder -- peroral endoscopic myotomy -- submucosal tunnel; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000002001
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Peroral endoscopic myotomy (POEM) is a rapidly evolving technique for the treatment of esophageal diverticulum. The aim of this study was to perform a systematic review and meta-analysis of the literature focusing on POEM for symptomatic esophageal diverticula, including an in-depth evaluation of its efficacy, safety, and limitations. A comprehensive literature search was completed to identify articles that examined the efficacy and safety of POEM for esophageal diverticula. Heterogeneity among studies was assessed using the I 2 statistic. Meta-regression and sensitivity analyses were performed to explore the sources of heterogeneity and assess potentially important covariates influencing the main outcomes. Primary endpoints such as rates of success, adverse events, and recurrences were evaluated. P values of ⩽0.05 were considered statistically significant. Nine studies with a total of 153 patients were enrolled. Pooled technical success, clinical success, adverse events, and recurrence rates were 99% [95% confidence interval (CI), 97–100%; I 2 = 0%), 94% (95% CI, 89–97%; I 2 = 24%), 2% (95% CI, 0–6%, I 2 = 0%), and 0% (95% CI, 0–1%; I 2 = 0%), respectively. The pooled perforation rate was 6% (95% CI, 1–11%; I 2 = 0%). Meta-regression analysis indicated that esophageal diverticula types and motility disorders were not associated with the clinical success rate ( P > 0.05). POEM is a feasible, safe, and effective treatment for symptomatic esophageal diverticula, with low adverse events and recurrence rates. Abstract : Supplemental Digital Content is available in the text.