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Role of endoscopic functional luminal imaging probe in predicting the outcome of gastric peroral endoscopic pyloromyotomy (with video).
Gastrointestinal Endoscopy ( IF 6.7 ) Pub Date : 2020-02-06 , DOI: 10.1016/j.gie.2020.01.044 Kia Vosoughi 1 , Yervant Ichkhanian 1 , Jérémie Jacques 2 , A Aziz Aadam 3 , Petros C Benias 4 , Ryan Law 5 , William L Hasler 5 , Andrew Canakis 6 , Olivier Ragi 2 , Joseph Triggs 3 , Nicole Bowers 5 , Olaya I Brewer Gutierrez 1 , Vivek Kumbhari 1 , Anthony N Kalloo 1 , Robert S Bulat 1 , John E Pandolfino 7 , Mouen A Khashab 1
Gastrointestinal Endoscopy ( IF 6.7 ) Pub Date : 2020-02-06 , DOI: 10.1016/j.gie.2020.01.044 Kia Vosoughi 1 , Yervant Ichkhanian 1 , Jérémie Jacques 2 , A Aziz Aadam 3 , Petros C Benias 4 , Ryan Law 5 , William L Hasler 5 , Andrew Canakis 6 , Olivier Ragi 2 , Joseph Triggs 3 , Nicole Bowers 5 , Olaya I Brewer Gutierrez 1 , Vivek Kumbhari 1 , Anthony N Kalloo 1 , Robert S Bulat 1 , John E Pandolfino 7 , Mouen A Khashab 1
Affiliation
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BACKGROUND AND AIMS
Endoluminal functional luminal imaging probe (EndoFLIP) is an imaging tool that measures the physiologic characteristics of GI sphincters. In this study, we used EndoFLIP to evaluate the association between the pyloric physiologic measurements and the clinical outcomes of gastric peroral endoscopic myotomy (G-POEM) in patients with refractory gastroparesis.
METHODS
Thirty-seven patients from 5 centers who underwent G-POEM for management of refractory gastroparesis and had EndoFLIP measurements were evaluated. Cross-sectional area (CSA), balloon pressure, and the distensibility index (DI) of the pylorus were evaluated by EndoFLIP at 40 mL and 50 mL balloon fills before and after G-POEM. One-year clinical success and change in gastric emptying study 3 months after the G-POEM procedure were compared with the EndoFLIP measurements.
RESULTS
Clinical success was achieved in 26 (70%) patients. Post-G-POEM CSA and DI were significantly higher in the clinical success group with both 40-mL volume distension (CSA: 89.9 ± 64.8 vs 172.5 ± 71.9 mm2, P =.003; DI: 5.8 ± 4.4 vs 8.8 ± 6.1 mm2/mm Hg, P =.043) and 50-mL volume distention (CSA: 140.1 ± 89.9 vs 237.5 ± 80.3 mm2, P =.003; DI: 5.6 ± 3.3 vs 9.9 ± 6.6 mm2/mm Hg, P =.049). CSA using 40-mL volume distention with an area under the curve of 0.83 yielded a specificity of 91% and a sensitivity of 71% at a cutoff point of 154 mm2.
CONCLUSIONS
Post-G-POEM CSA of the pylorus is associated with clinical success and improvement in a gastric emptying scan after G-POEM. EndoFLIP measurements of the pylorus have the potential to be used as a tool to predict the clinical outcome of G-POEM.
中文翻译：
内窥镜功能管腔成像探头在预测胃口内镜下幽门切开术预后的作用（视频）。
背景和目的腔内功能腔成像探针（EndoFLIP）是一种测量胃肠道括约肌生理特性的成像工具。在这项研究中，我们使用EndoFLIP评估了难治性胃轻瘫患者幽门生理测量值与胃口内镜下肌切开术（G-POEM）的临床结局之间的关联。方法评估了来自5个中心的37例接受G-POEM治疗难治性胃轻瘫并进行EndoFLIP测量的患者。在G-POEM之前和之后，通过EndoFLIP在40 mL和50 mL球囊填充量下评估幽门的截面积（CSA），球囊压力和扩张性指数（DI）。将G-POEM手术后3个月的一年临床成功率和胃排空变化与EndoFLIP测量结果进行了比较。结果26例（70％）患者获得了临床成功。G-POEM后的CSA和DI在临床成功组中均显着高于40 mL体积膨胀（CSA：89.9±64.8 vs 172.5±71.9 mm2，P = .003; DI：5.8±4.4 vs 8.8±6.1 mm2 / mm Hg，P = .043）和50-mL体积膨胀（CSA：140.1±89.9 vs 237.5±80.3 mm2，P = .003; DI：5.6±3.3 vs 9.9±6.6 mm2 / mm Hg，P = .049 ）。使用面积为0.83的曲线下面积为40 mL的CSA在截止点154 mm2处产生的特异性为91％，灵敏度为71％。结论幽门的G-POEM后CSA与G-POEM后的临床成功和胃排空扫描的改善有关。幽门的EndoFLIP测量有潜力用作预测G-POEM临床结果的工具。
更新日期：2020-02-06
中文翻译：
内窥镜功能管腔成像探头在预测胃口内镜下幽门切开术预后的作用（视频）。
背景和目的腔内功能腔成像探针（EndoFLIP）是一种测量胃肠道括约肌生理特性的成像工具。在这项研究中，我们使用EndoFLIP评估了难治性胃轻瘫患者幽门生理测量值与胃口内镜下肌切开术（G-POEM）的临床结局之间的关联。方法评估了来自5个中心的37例接受G-POEM治疗难治性胃轻瘫并进行EndoFLIP测量的患者。在G-POEM之前和之后，通过EndoFLIP在40 mL和50 mL球囊填充量下评估幽门的截面积（CSA），球囊压力和扩张性指数（DI）。将G-POEM手术后3个月的一年临床成功率和胃排空变化与EndoFLIP测量结果进行了比较。结果26例（70％）患者获得了临床成功。G-POEM后的CSA和DI在临床成功组中均显着高于40 mL体积膨胀（CSA：89.9±64.8 vs 172.5±71.9 mm2，P = .003; DI：5.8±4.4 vs 8.8±6.1 mm2 / mm Hg，P = .043）和50-mL体积膨胀（CSA：140.1±89.9 vs 237.5±80.3 mm2，P = .003; DI：5.6±3.3 vs 9.9±6.6 mm2 / mm Hg，P = .049 ）。使用面积为0.83的曲线下面积为40 mL的CSA在截止点154 mm2处产生的特异性为91％，灵敏度为71％。结论幽门的G-POEM后CSA与G-POEM后的临床成功和胃排空扫描的改善有关。幽门的EndoFLIP测量有潜力用作预测G-POEM临床结果的工具。
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