Impedance planimetry values for predicting clinical response following peroral endoscopic myotomy.
Impedance planimetry values for predicting clinical response following peroral endoscopic myotomy.
复制标题
经口内镜肌切开术后预测临床反应的阻抗面积法值。
DOI：
10.1055/a-1268-7713
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发表时间：
2021-06
期刊：
影响因子：
9.3
通讯作者：
Khashab MA
中科院分区：
文献类型：
--
作者：
Moran RA;Brewer Gutierrez OI;Rahden B;Chang K;Ujiki M;Yoo IK;Gulati S;Romanelli J;Al-Nasser M;Shimizu T;Hedberg MH;Cho JY;Hayee B;Desilets D;Filser J;Fortinsky K;Haji A;Fayad L;Sanaei O;Dbouk M;Kumbhari V;Wolf BJ;Elmunzer BJ;Khashab MA
阻抗测面法作为一种提高贲门失弛缓症内镜和手术治疗临床效果的工具，越来越受到关注。本研究的主要目的是确定阻抗面积测量是否可以预测经口内镜肌切开术（POEM）后的临床反应和反流。根据前瞻性数据库和回顾性图表审查，对接受POEM的贲门失弛缓症患者进行了一项多中心队列研究。包括在POEM前后接受阻抗平面测量的患者。临床应答定义为Eckardt评分≤3。对于与临床反应和反流发展相关的不同阻抗测面积法测量，确定了十倍交叉验证的曲线下面积（AUC）值。在纳入的290例患者中，91.7%（266/290）有临床应答，39.4%（108/274）在POEM后发生反流。临床反应的最具预测性的阻抗测面法测量值为：横截面积变化百分比（%ΔCSA）和扩张性指数变化百分比（%ΔDI），AUC分别为0.75和0.73。确定临床应答的%ΔCSA和%ΔDI的最佳临界值分别为360%和272%的变化。阻抗测面积法值在预测POEM后反流方面要差得多，AUC范围为0.40至0.62。CSA和扩张性指数的百分比变化是临床反应的最具预测性的指标，具有中等的预测能力。阻抗面积法预测反流POEM后的值显示出较弱的预测能力。
There is growing interest in developing impedance planimetry as a tool to enhance the clinical outcomes for endoscopic and surgical management of achalasia. The primary aim of this study was to determine whether impedance planimetry measurements can predict clinical response and reflux following peroral endoscopic myotomy (POEM). A multicenter cohort study of patients with achalasia undergoing POEM was established from prospective databases and retrospective chart reviews. Patients who underwent impedance planimetry before and after POEM were included. Clinical response was defined as an Eckardt score of ≤3. Tenfold cross-validated area under curve (AUC) values were established for the different impedance planimetry measurements associated with clinical response and reflux development. Of the 290 patients included, 91.7% (266/290) had a clinical response and 39.4% (108/274) developed reflux following POEM. The most predictive impedance planimetry measurements for a clinical response were: percent change in cross-sectional area (%ΔCSA) and percent change in distensibility index (%ΔDI), with AUCs of 0.75 and 0.73, respectively. Optimal cutoff values for %ΔCSA and %ΔDI to determine a clinical response were a change of 360% and 272%, respectively. Impedance planimetry values were much poorer at predicting post-POEM reflux, with AUCs ranging from 0.40 to 0.62. Percent change in CSA and distensibility index were the most predictive measures of a clinical response, with a moderate predictive ability. Impedance planimetry values for predicting reflux following POEM showed weak predictive capacity.
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影响因子：
3.4
作者：
Yoo IK;Choi SA;Kim WH;Hong SP;Cakir OO;Cho JY
通讯作者：
Cho JY
影响因子：
158.5
作者：
Werner, Yuki B.;Hakanson, Bengt;Roesch, Thomas
通讯作者：
Roesch, Thomas
影响因子：
24.5
作者：
Lundell, LR;Dent, J;Wallin, L
通讯作者：
Wallin, L
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/s00464-013-3121-2
发表时间：
2013-12-01
影响因子：
3.1
作者：
Teitelbaum, Ezra N.;Boris, Lubomyr;Hungness, Eric S.
通讯作者：
Hungness, Eric S.