{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:46:38Z","timestamp":1773269198820,"version":"3.50.1"},"reference-count":11,"publisher":"Pensoft Publishers","issue":"3","license":[{"start":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:00:00Z","timestamp":1688083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>The epiphrenic esophageal diverticulum is a rare non-malignant condition that is commonly associated with motility disorders. It would normally be treated surgically, but with the advancement of endoscopy techniques, peroral endoscopic myotomy with septotomy (D-POEM) has shown its benefits in coping with the symptoms. We present a case of a 71-year-old woman with increasing symptoms of dysphagia, weight loss and imaging data showing a large epiphrenic diverticulum. We treated her using peroral endoscopic myotomy combined with septotomy of the diverticular septum. The procedure showed excellent results with reducing the amount of contrast materials retained in it, improving the quality of life of the patient, and increasing her weight. There were minimal adverse events and no perforations or severe adverse effects occurred. D-POEM is a new and rapidly evolving procedure that is proving to be a safe and effective method of treating epiphrenic esophageal diverticulum.<\/jats:p>","DOI":"10.3897\/folmed.65.e83893","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T13:30:41Z","timestamp":1688045441000},"page":"490-494","source":"Crossref","is-referenced-by-count":1,"title":["Initial experience in target peroral endoscopic submucosal myotomy combined with septotomy for epiphrenic diverticulum"],"prefix":"10.3897","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1668-362X","authenticated-orcid":true,"given":"Nikola","family":"Boyanov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Andonov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1520-5813","authenticated-orcid":true,"given":"Katina","family":"Shtereva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katerina","family":"Madzharova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolay","family":"Stoynov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desislava","family":"Dimitrova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7449-7756","authenticated-orcid":true,"given":"Ivan","family":"Yankov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2023,6,30]]},"reference":[{"key":"83893_B1","doi-asserted-by":"crossref","unstructured":"1. Baker ME, Zuccaro Jr G, Achkar E, et al. Esophageal diverticula: patient assessment. Semin Thorac Cardiovasc Surg 1999; 1(4):326\u201336.","DOI":"10.1016\/S1043-0679(99)70077-8"},{"key":"83893_B2","doi-asserted-by":"crossref","unstructured":"2. Sato H, Takeuchi M, Hashimoto S, et al. Esophageal diverticulum: New perspectives in the era of minimally invasive endoscopic treatment. World J Gastroenterol 2019; 25(12):1457\u201364.","DOI":"10.3748\/wjg.v25.i12.1457"},{"key":"83893_B3","doi-asserted-by":"crossref","unstructured":"3. Zaninotto G, Portale G, Costantini M, et al. Therapeutic strategies for epiphrenic diverticula: systematic review. World J Surg 2011; 35(7):1447\u201353.","DOI":"10.1007\/s00268-011-1065-z"},{"key":"83893_B4","doi-asserted-by":"crossref","unstructured":"4. Basile P, Gonzalez JM, Le Mouel JP, et al. Peroral endoscopic myotomy with septotomy for the treatment of distal esophageal diverticula (D-POEM). Surg Endosc 2020; 34(5):2321\u20135.","DOI":"10.1007\/s00464-019-07354-0"},{"key":"83893_B5","doi-asserted-by":"crossref","unstructured":"5. Soares RV, Montenovo M, Pellegrini CA, et al. Laparoscopy as the initial approach for epiphrenic diverticula. Surg Endosc 2011; 25(12):3740\u20136.","DOI":"10.1007\/s00464-011-1779-x"},{"key":"83893_B6","doi-asserted-by":"crossref","unstructured":"6. Tedesco P, Fisichella PM, Way LW, et al. Cause and treatment of epiphrenic diverticula. Am J Surg 2005; 190(6):891\u20134.","DOI":"10.1016\/j.amjsurg.2005.08.016"},{"key":"83893_B7","doi-asserted-by":"crossref","unstructured":"7. Demeter M, B\u00e1nov\u010din Jr P, \u010euri\u010dek M, et al. Peroral endoscopic myotomy in achalasia and large epiphrenic diverticulum. Digestive Endoscopy 2018; 30:260\u20132.","DOI":"10.1111\/den.12961"},{"key":"83893_B8","doi-asserted-by":"crossref","unstructured":"8. Feu\u00dfner H, H\u00fcser N, Wilhelm D, et al. Operative Therapie von Divertikeln der Speiser\u00f6hre: Endoskopisch oder offen? [Surgical treatment of esophageal diverticula: Endoscopic or open approach?]. Chirurg 2017; 88(3):196\u2013203 (German).","DOI":"10.1007\/s00104-016-0344-5"},{"key":"83893_B9","doi-asserted-by":"crossref","unstructured":"9. Herbella FA, Patti MG. Modern pathophysiology and treatment of esophageal diverticula. Langenbecks Arch Surg 2012; 397(1):29\u201335.","DOI":"10.1007\/s00423-011-0843-2"},{"key":"83893_B10","doi-asserted-by":"crossref","unstructured":"10. Demeter M, \u010euri\u010dek M, Vor\u010d\u00e1k M, et al. S-POEM in treatment of achalasia and esophageal epiphrenic diverticula - single center experience. Scand J Gastroenterol 2020; 55(4):509\u2013514.","DOI":"10.1080\/00365521.2020.1745881"},{"key":"83893_B11","doi-asserted-by":"crossref","unstructured":"11. Ward MA, Gitelis M, Patel L, et al. Outcomes in patients with over 1-year follow-up after peroral endoscopic myotomy (POEM). Surg Endosc 2017; 31(4):1550\u20137.","DOI":"10.1007\/s00464-016-5130-4"}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/83893\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/83893\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=83893&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T13:30:45Z","timestamp":1688045445000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/83893\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,30]]},"references-count":11,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,6,30]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.65.e83893","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2023,6,30]]}}}