Assessment of Clinical Outcomes after Peroral Endoscopic Myotomy via Esophageal Distensibility Measurements with the Endoluminal Functional Lumen Imaging Probe.
Assessment of Clinical Outcomes after Peroral Endoscopic Myotomy via Esophageal Distensibility Measurements with the Endoluminal Functional Lumen Imaging Probe.
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DOI：
10.5009/gnl18233
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发表时间：
2019-01-15
期刊：
影响因子：
3.4
通讯作者：
Cho JY
中科院分区：
文献类型：
--
作者：
Yoo IK;Choi SA;Kim WH;Hong SP;Cakir OO;Cho JY
腔内功能性管腔成像探头（EndoFLIP）是一种使临床医生能够测量食管容积控制扩张的模式。本研究旨在评估EndoFLIP在经口内镜肌切开术（POEM）治疗贲门失弛缓症患者中的效用。我们假设扩张指数（DI）的改善与POEM术后临床结局相关。纳入了在Cha Bundang Medical Center接受POEM治疗贲门失弛缓症的患者。使用EndoFLIP评估POEM前后食管下括约肌（LES）压力的生理测量值。使用Eckardt评分记录患者的症状。本研究共纳入52例贲门失弛缓症患者。POEM后DI低于7（30或40 mL）的患者POEM后不完全缓解率显著较高（p=0.001）。POEM后LES压力或积分松弛压的变化也与不完全反应显著相关（分别为p=0.026和p=0.016）。多变量分析显示，POEM后DI <7是POEM后不完全缓解的最重要预测因素（p=0.004）。较低的POEM后DI值与不完全的POEM后反应相关。因此，使用EndoFLIP进行POEM后食管胃交界处的DI是预测贲门失弛缓症患者POEM临床结局的有用指标。
Endoluminal functional lumen imaging probe (EndoFLIP) is a modality that enables clinicians to measure volume-controlled distension of the esophagus. This study aimed to assess the utility of EndoFLIP in patients who had achalasia treated with peroral endoscopic myotomy (POEM). We hypothesized that improvement in the distensibility index (DI) is correlated with the postoperative clinical outcome of POEM. Patients who underwent POEM for achalasia at Cha Bundang Medical Center were included. Physiological measurements of the lower esophageal sphincter (LES) pressure before and after POEM were assessed using EndoFLIP. Patients’ symptoms were recorded using the Eckardt score. A total of 52 patients with achalasia were included in this study. Patients with a post-POEM DI below 7 (30 or 40 mL) had a significantly higher rate of incomplete response after POEM (p=0.001). Changes in LES pressure or integrated relaxation pressure after POEM were also significantly associated with an incomplete response (p=0.026 and p=0.016, respectively). Multivariate analysis showed that post-POEM DI <7 was the most important predictor of an incomplete response after POEM (p=0.004). Lower post-POEM DI values were associated with an incomplete post-POEM response. Therefore, post-POEM DI at the esophagogastric junction using EndoFLIP is a useful index for predicting the clinical outcome of POEM in patients with achalasia.
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影响因子：
7.7
作者：
Kwiatek, Monika A.;Pandolfino, John E.;Hirano, Ikuo;Kahrilas, Peter J.
通讯作者：
Kahrilas, Peter J.
影响因子：
29.4
作者：
Rohof, Wout O.;Hirsch, David P.;Boeckxstaens, Guy E.
通讯作者：
Boeckxstaens, Guy E.
DOI：
10.1007/s00464-012-2484-0
发表时间：
2013-02-01
影响因子：
3.1
作者：
Rieder, Erwin;Swanstrom, Lee L.;Dunst, Christy M.
通讯作者：
Dunst, Christy M.
影响因子：
9.3
作者：
Inoue, H.;Minami, H.;Kudo, S.
通讯作者：
Kudo, S.
影响因子：
29.4
作者：
ECKARDT, VF;AIGNHERR, C;BERNHARD, G
通讯作者：
BERNHARD, G