Third-space endoscopy: Current techniques, clinical applications, and future directions.

47 Comparative data remain underpowered but suggest equivalence in short-term outcomes between Z-POEM and FES, with a possible trend toward higher clinical success and lower recurrence with tunneling approaches. 49 , 50 However, these differences are modest and subject to study design, follow-up duration, and the definition of recurrence, raising concerns about overinterpretation of superiority claims.

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