Feasibility and safety of per‐oral endoscopic septotomy for Killian‐Jamieson diverticulum: Case series with video

• Published in: Digestive endoscopy Vol. 36; no. 8; pp. 895 - 903
• Main Authors: Tanaka, Ippei, Shimamura, Yuto, Inoue, Haruhiro, Azuma, Daisuke, Ushikubo, Kei, Yamamoto, Kazuki, Okada, Hiroki, Kimoto, Yoshiaki, Nishikawa, Yohei, Owada, Kaori, Tanabe, Mayo, Onimaru, Manabu
• Format: Journal Article
• Language: English
• Published: Australia 01.08.2024
• Subjects: Aged; Aged, 80 and over; Deglutition Disorders - etiology; Deglutition Disorders - surgery; Diverticulum, Esophageal - surgery; esophageal diseases; esophagopharyngeal diverticulum; Feasibility Studies; Female; Humans; Male; Middle Aged; Natural Orifice Endoscopic Surgery - adverse effects; Natural Orifice Endoscopic Surgery - methods; Operative Time; per‐oral endoscopic septotomy; Retrospective Studies; Treatment Outcome; esophagopharyngeal diverticulum; per‐oral endoscopic septotomy; esophageal diseases
• DOI: 10.1111/den.14738
• ISSN: 0915-5635; 1443-1661

Background and Aims Killian‐Jamieson diverticulum (KJD) is a relatively uncommon variant of pharyngoesophageal diverticula, distinct from the more prevalent Zenker diverticulum. However, literature on endoscopic management of KJD remains limited. This study aimed to elucidate the efficacy and safety of peroral endoscopic septotomy (POES) as a treatment approach for symptomatic KJD. Methods In this retrospective observational study, we investigated the outcomes of nine consecutive patients who underwent POES for KJD between January 2019 and May 2023. Follow‐up data of at least 2 months post‐treatment were analyzed. The primary outcome measure was the technical success rate of POES. Secondary outcomes encompassed the clinical success rate, defined as symptomatic improvement 2 months after POES, and the incidence of adverse events. Results All patients presented with dysphagia, with a median symptom duration of 6 months (interquartile range [IQR]: 3–12 months). The median diverticulum size was 32 mm (IQR: 24–42 mm). The median duration of the operation time was 66 min (IQR: 60–109). A 100% technical success rate was achieved, with complete closure of the defect in all cases. There were no adverse events related to this treatment. The median hospitalization duration was 5 days (IQR: 4–6), and the clinical success rate was 88.9%. Follow‐up barium esophagograms exhibited significant improvement in the flow of the barium for all patients. Conclusions Despite the relatively limited case volume, our findings underscore that POES is a safe and efficacious approach for managing symptomatic KJD.