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Article History

Received: 11 February 2025

Accepted: 17 June 2025

First Online: 3 July 2025

Declarations

:

: Ethical approval for this study was obtained from the Institutional Review Board of the Al-Thawra Modern General Hospital in Sana’a, Yemen (IRB-TMGH-2022-013). Written informed consent was obtained from all participants or their legal guardians before study inclusion. The consent process involved a detailed explanation of the study purpose, procedures, potential risks (e.g., endoscopic perforation < 1–5% and surgical complications 10–30%), and benefits (e.g., improved swallowing). Participants were also informed of their right to withdraw from the study at any time, without prejudice. Mitigation strategies for potential risks include comprehensive preoperative assessments, procedures performed by experienced clinicians, availability of emergency care, and diligent post-operative monitoring. For participants with psychiatric conditions (9.1%, n = 2), additional informed consent was obtained for potential mental-health referrals. All patient data were anonymized, and confidentiality was maintained in strict accordance with the Declaration of Helsinki and its later amendments or comparable ethical standards.

: Not applicable. This manuscript does not contain any individual data (including details, images, or videos) that require specific consent for publication.

: The authors declare no competing interests.