Esophageal distensibility measurement: impact on clinical management and procedure length
Autor: | P. J. Pasricha, Patricia Garcia, Abhishek Agnihotri, Frances Onyimba, M. McKnight, Kristle Lynch, Sameer Dhalla, Danielle Hoo-Fatt, John O. Clarke, Ellen M. Stein, Francis Okeke, Nitin K. Ahuja |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Operative Time Achalasia Esophageal Diseases Severity of Illness Index Hiatal hernia Young Adult 03 medical and health sciences Esophagus 0302 clinical medicine Electric Impedance Pressure medicine Humans Prospective Studies Eosinophilic esophagitis Prospective cohort study Aged Retrospective Studies Aged 80 and over business.industry Medical record Gastroenterology Retrospective cohort study General Medicine Middle Aged medicine.disease Dysphagia medicine.anatomical_structure 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Esophagoscopy Radiology medicine.symptom business |
Zdroj: | Diseases of the Esophagus. 30:1-8 |
ISSN: | 1442-2050 1120-8694 |
Popis: | Luminal distensibility measurement has demonstrated relevance to various disease processes, though its effects on clinical decision-making have been less well understood. This study aims to characterize the clinical impact of impedance planimetry measurement as well as the learning curve associated with its use in the esophagus. A single provider performed distensibility measurement in conjunction with upper endoscopy for a variety of clinical indications with the functional lumen imaging probe (FLIP) over a period of 21 months. Procedural data were prospectively collected and, along with medical records, retrospectively reviewed. Seventy-three procedures (70 patients) underwent esophageal distensibility measurement over the timeline of this study. The most common procedural indications were known or suspected achalasia (32.9%), dysphagia with connective tissue disease (13.7%), eosinophilic esophagitis (12.3%), and dysphagia with prior fundoplication (9.6%). FLIP results independently led to a change in management in 29 (39.7%) cases and supported a change in management in an additional 15 (20.5%) cases. The most common change in management was a new or amended therapeutic procedure (79.5%). Procedural time added by distensibility measurement was greater among earlier cases than among later cases. The median time added overall was 5 minutes and 46 seconds. Procedural time added varied significantly by procedural indication, but changes in management did not. Distensibility measurement added meaningful diagnostic information that impacted therapeutic decision-making in the majority of cases in which it was performed. Procedural time added by this modality is typically modest and decreases with experience. |
Databáze: | OpenAIRE |
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