Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review

Autor: Hyeon Jeong Goong, Shin Hee Kim, Su Jin Hong
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Myotomy
medicine.medical_treatment
General Anesthesia
Achalasia
Laryngology
Intraoperative Period
0302 clinical medicine
Anesthesiology
Medicine and Health Sciences
Medicine
Anesthesia
Multidisciplinary
medicine.diagnostic_test
Pharmaceutics
Dysphagia
Research Assessment
Chemistry
Treatment Outcome
Barium
030220 oncology & carcinogenesis
Physical Sciences
030211 gastroenterology & hepatology
Radiology
Esophagoscopy
medicine.symptom
Anatomy
Research Article
Chemical Elements
medicine.medical_specialty
Systematic Reviews
Imaging Techniques
Science
Lumen (anatomy)
Surgical and Invasive Medical Procedures
Research and Analysis Methods
03 medical and health sciences
Esophagus
Drug Therapy
Diagnostic Medicine
Humans
Reflux esophagitis
business.industry
Biology and Life Sciences
Endoscopy
medicine.disease
Gastrointestinal Tract
Esophageal Achalasia
Otorhinolaryngology
business
Esophagitis
Digestive System
Zdroj: PLoS ONE, Vol 15, Iss 6, p e0234295 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: AimThe functional lumen imaging probe (FLIP) is a recently developed technique to evaluate the esophagogastric junction (EGJ) distensibility. Unlike timed barium esophagogram (TBE) and high-resolution manometry (HRM), FLIP can be used during peroral endoscopic myotomy (POEM). The aim of this study was to evaluate the association of intraoperative FLIP parameters with clinical outcomes as recorded in a single-center database and to investigate a systematic review of literatures.MethodsWe reviewed consecutive patients diagnosed with achalasia and scheduled for POEM between June 2016 and March 2019 in our tertiary referral hospital. All patients underwent intraoperative FLIP assessment during POEM. The final FLIP measurements were compared between the patients with good and poor clinical response. We comprehensively reviewed studies evaluating whether intraoperative FLIP measurements reflected clinical outcomes.ResultsWe evaluated 23 patients with achalasia who underwent intraoperative FLIP before and after POEM. Two exhibited poor clinical responses after 3 months (Eckardt scores = 3). The final distensibility index (DI) did not differ significantly between good and poor responders (5.01 [4.52] vs. 4.91 [3.63-6.20] mm2/mmHg at a balloon distension of 50-mL, median [IQR], P = 0.853). The final DI did not differ significantly between post-POEM reflux esophagitis and non-reflux esophagitis groups (6.20 [5.15] vs. 4.23 [1.79] mm2/mmHg at a balloon distension of 50-mL, median [IQR], P = 0.075).ConclusionsA systematic review of both prospective and retrospective studies including our data indicated that the final intraoperative FLIP measurements did not differ significantly between good and poor responders. Further study with more patients is necessary to explore whether FLIP can predict short- and long-term clinical responses.
Databáze: OpenAIRE
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