Role of endoscopic functional luminal imaging probe in predicting the outcome of gastric peroral endoscopic pyloromyotomy (with video).


Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
06 2020
Historique:
received: 12 09 2019
accepted: 22 01 2020
pubmed: 9 2 2020
medline: 18 2 2021
entrez: 9 2 2020
Statut: ppublish

Résumé

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. 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. 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 mm 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.

Sections du résumé

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 mm
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.

Identifiants

pubmed: 32035074
pii: S0016-5107(20)30102-4
doi: 10.1016/j.gie.2020.01.044
pii:
doi:

Substances chimiques

Phenobarbital YQE403BP4D

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1289-1299

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2020 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Kia Vosoughi (K)

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Yervant Ichkhanian (Y)

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Jérémie Jacques (J)

Gastroenterology Department, Dupuytren University Hospital, Limoges, France.

A Aziz Aadam (AA)

Division of Gastroenterology, Northwestern University, Chicago, Illinois, USA.

Petros C Benias (PC)

Division of Gastroenterology, Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, Northwell Health System, New Hyde Park, New York, USA.

Ryan Law (R)

Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.

William L Hasler (WL)

Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.

Andrew Canakis (A)

Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.

Olivier Ragi (O)

Gastroenterology Department, Dupuytren University Hospital, Limoges, France.

Joseph Triggs (J)

Division of Gastroenterology, Northwestern University, Chicago, Illinois, USA.

Nicole Bowers (N)

Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.

Olaya I Brewer Gutierrez (OI)

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Vivek Kumbhari (V)

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Anthony N Kalloo (AN)

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Robert S Bulat (RS)

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, USA.

John E Pandolfino (JE)

Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Mouen A Khashab (MA)

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, USA.

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