Epiphrenic diverticulum: is diverticular peroral endoscopic myotomy (D-POEM) enough or do we need to go one step forward?

We present a review of 9 patients (44.4% women, 67.7 +/- 7.3 years) who had undergone diverticular peroral endoscopic myotomy (D-POEM) for symptomatic epiphrenic diverticula (ED) at our Unit from July 2020 to April 2024. One patient had received prior treatment, specifically, laparoscopic resection of the diverticulum, Heller myotomy and partial funduplication in 2014 with clinical improvement. The predominant symptoms were dysphagia and regurgitation and the average Eckardt Score (ES) were 6 +/- 1,1. A co-existing esophageal motility disorder was documented in 8 (88.9%).