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Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review
AIM: The 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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282640/ https://www.ncbi.nlm.nih.gov/pubmed/32516319 http://dx.doi.org/10.1371/journal.pone.0234295 |
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author | Goong, Hyeon Jeong Hong, Su Jin Kim, Shin Hee |
author_facet | Goong, Hyeon Jeong Hong, Su Jin Kim, Shin Hee |
author_sort | Goong, Hyeon Jeong |
collection | PubMed |
description | AIM: The 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. METHODS: We 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. RESULTS: We 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] mm(2)/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] mm(2)/mmHg at a balloon distension of 50-mL, median [IQR], P = 0.075). CONCLUSIONS: A 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. |
format | Online Article Text |
id | pubmed-7282640 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-72826402020-06-17 Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review Goong, Hyeon Jeong Hong, Su Jin Kim, Shin Hee PLoS One Research Article AIM: The 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. METHODS: We 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. RESULTS: We 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] mm(2)/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] mm(2)/mmHg at a balloon distension of 50-mL, median [IQR], P = 0.075). CONCLUSIONS: A 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. Public Library of Science 2020-06-09 /pmc/articles/PMC7282640/ /pubmed/32516319 http://dx.doi.org/10.1371/journal.pone.0234295 Text en © 2020 Goong et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Goong, Hyeon Jeong Hong, Su Jin Kim, Shin Hee Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review |
title | Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review |
title_full | Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review |
title_fullStr | Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review |
title_full_unstemmed | Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review |
title_short | Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review |
title_sort | intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: a single-institute experience and systematic review |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282640/ https://www.ncbi.nlm.nih.gov/pubmed/32516319 http://dx.doi.org/10.1371/journal.pone.0234295 |
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