Classifying Esophageal Motility by FLIP Panometry: A Study of 722 Subjects With Manometry.

Autor:	Carlson DA; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Gyawali CP; Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA., Khan A; Department of Medicine, Division of Gastroenterology and Hepatology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York, USA., Yadlapati R; Division of Gastroenterology, University of California San Diego, La Jolla, California, USA., Chen J; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA., Chokshi RV; Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA., Clarke JO; Division of Gastroenterology & Hepatology, Stanford University School of Medicine, Redwood City, California, USA., Garza JM; GI Care for Kids, Neurogastroenterology and Motility Program Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Jain AS; Department of Internal Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia, USA., Katz P; Department of Gastroenterology Weill Cornell Medical Center, New York, New York, USA., Konda V; Division of Gastroenterology Baylor University Medical Center, Dallas, Texas, USA., Lynch K; Division of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA., Schnoll-Sussman FH; Department of Gastroenterology Weill Cornell Medical Center, New York, New York, USA., Spechler SJ; Division of Gastroenterology Baylor University Medical Center, Dallas, Texas, USA.; Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas, USA., Vela MF; Division of Gastroenterology, Mayo Clinic Arizona, Scottsdale, Arizona, USA., Prescott JE; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Baumann AJ; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Donnan EN; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Kou W; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Kahrilas PJ; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Pandolfino JE; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2021 Dec 01; Vol. 116 (12), pp. 2357-2366.
DOI:	10.14309/ajg.0000000000001532
Abstrakt:	Introduction: Functional luminal imaging probe (FLIP) panometry can evaluate esophageal motility in response to sustained esophageal distension at the time of sedated endoscopy. This study aimed to describe a classification of esophageal motility using FLIP panometry and evaluate it against high-resolution manometry (HRM) and Chicago Classification v4.0 (CCv4.0). Methods: Five hundred thirty-nine adult patients who completed FLIP and HRM with a conclusive CCv4.0 diagnosis were included in the primary analysis. Thirty-five asymptomatic volunteers ("controls") and 148 patients with an inconclusive CCv4.0 diagnosis or systemic sclerosis were also described. Esophagogastric junction (EGJ) opening and the contractile response (CR) to distension (i.e., secondary peristalsis) were evaluated with a 16-cm FLIP during sedated endoscopy and analyzed using a customized software program. HRM was classified according to CCv4.0. Results: In the primary analysis, 156 patients (29%) had normal motility on FLIP panometry, defined by normal EGJ opening and a normal or borderline CR; 95% of these patients had normal motility or ineffective esophageal motility on HRM. Two hundred two patients (37%) had obstruction with weak CR, defined as reduced EGJ opening and absent CR or impaired/disordered CR, on FLIP panometry; 92% of these patients had a disorder of EGJ outflow per CCv4.0. Discussion: Classifying esophageal motility in response to sustained distension with FLIP panometry parallels the swallow-associated motility evaluation provided with HRM and CCv4.0. Thus, FLIP panometry serves as a well-tolerated method that can complement, or in some cases be an alternative to HRM, for evaluating esophageal motility disorders. (Copyright © 2021 by The American College of Gastroenterology.)
Databáze:	MEDLINE
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