Evidence map›Paper›PMID 39160304›Full record

ArticleSurgical endoscopy2024

The safety and efficacy of endoscopic approaches for the management of Zenker's diverticulum: a multicentre retrospective study.

Benjamin Norton, Katie Siggens, Apostolis Papaefthymiou, Andrea Telese, Margaret Duku, Alberto Murino, Gavin Johnson, Charles Murray, Borzoueh Mohammadi, Muntzer Mughal and 4 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Submucosal Injection-Guided Septotomy for Zenker's Diverticulum: Finding the Middle Ground.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026
    Article
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Benjamin NortonDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK. Benjamin.norton@nhs.net.ORCID 0000-0003-2058-3162
Katie SiggensDepartment of Gastroenterology, Portsmouth University Hospitals, Portsmouth, UK.
Apostolis PapaefthymiouDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.
Andrea TeleseDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.
Margaret DukuDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.
Alberto MurinoDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.
Gavin JohnsonDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.
Charles MurrayDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.
Borzoueh MohammadiDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.
Muntzer MughalDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.
Raf BisschopsDepartment of Gastroenterology and Hepatology, UZ Leuven. TARGID, Louvain, KU, Belgium.
Pradeep BhandariDepartment of Gastroenterology, Portsmouth University Hospitals, Portsmouth, UK.
Martin BirchallRoyal National Ear Nose and Throat and Eastman Dental Hospitals, University College London Hospital, London, UK.
Rehan HaidryDigestive Diseases & Surgical Institute, Cleveland Clinic London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMinimally invasive endoscopic options are safe and effective alternatives to surgery for the treatment of symptomatic Zenker's diverticulum (ZD). However, there is no consensus on the gold-standard approach. We compared the safety and efficacy of Zenker's peroral endoscopic myotomy (Z-POEM), flexible diverticulotomy (FD), and rigid diverticulotomy (RD) for the management of ZD.

methodsPatients undergoing treatment for ZD at three UK tertiary referral centres were identified and analysed between 2013 and 2023. Patient demographics, procedural details, clinical success, and 30-day adverse events (AE) were recorded. The primary outcomes were technical and clinical success defined as a fall in Dakkak and Bennett dysphagia score to ≤ 1 without re-intervention.

resultsThere was no difference in baseline characteristics amongst 126 patients undergoing intervention (50 RD, 31 FD, 45 Z-POEM). Technical success for RD, FD, and Z-POEM was 80%, 100%, and 100%, respectively (p < 0.001). Over a mean follow-up of 11.0 months (95% CI 8.2-13.9), clinical success amongst those treated was 85.3% (RD), 74.1% (FD), and 83.7% (Z-POEM; p = 0.48) with recurrence in 17.2% (RD), 20.0% (FD), and 8.3% (Z-POEM; p = 0.50). AEs were equivalent between groups (p = 0.98). During this time, 11 patients underwent surgical myotomy with low clinical success (36.4%) and high morbidity.

conclusionEndoscopic options for the treatment of ZD show equivalent rates of success, but failed RD often led to open myotomy with worse outcomes. Flexible endoscopic modalities are both safe and highly effective treatments that may be considered first-line in experienced centres and should be offered before surgery.

Indexed as

EsophagoscopyZenker DiverticulumAgedAged, 80 and overFemaleHumansMaleMiddle AgedMyotomyRetrospective StudiesTreatment OutcomeFlexible diverticulotomyPeroral endoscopic myotomyPharyngeal pouchRigid diverticulotomyZenker’s diverticulum

Identifiers

PMID39160304
PMCPMC11458695

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.