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Martina Scharitzer, Johannes Lenglinger, Wolfgang Schima, Michael Weber, Claudia Ringhofer, Peter Pokieser
OBJECTIVES: To compare videofluoroscopy that included a tablet test with impedance planimetry (EndoFLIP(®)) for the evaluation of oesophageal stenosis in patients with dysphagia. METHODS: In 56 patients, videofluoroscopic examinations following the transit of a 14-mm tablet were retrospectively reviewed and correlated with impedance planimetry findings, a catheter-based method using impedance planimetry to display the oesophageal diameter estimates. Additional findings assessed were the occurrence of symptoms during tablet passage and evaluation of oesophageal motility...
August 23, 2016: European Radiology
F A Ponds, A J Bredenoord, B F Kessing, A J P M Smout
BACKGROUND: Manometric criteria to diagnose achalasia are absent peristalsis and incomplete relaxation of the esophagogastric junction (EGJ), determined by an integrated relaxation pressure (IRP) >15 mm Hg. However, EGJ relaxation seems normal in a subgroup of patients with typical symptoms of achalasia, no endoscopic abnormalities, stasis on timed barium esophagogram (TBE), and absent peristalsis on high-resolution manometry (HRM). The aim of our study was to further characterize these patients by measuring EGJ distensibility and assessing the effect of achalasia treatment...
July 25, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Mikael Petrosyan, Adham M Khalafallah, Phillip C Guzzetta, Anthony D Sandler, Anil Darbari, Timothy D Kane
BACKGROUND: Surgical management of esophageal achalasia (EA) in children has transitioned over the past 2 decades to predominantly involve laparoscopic Heller myotomy (LHM) or minimally invasive surgery (MIS). More recently, peroral endoscopic myotomy (POEM) has been utilized to treat achalasia in children. Since the overall experience with surgical management of EA is contingent upon disease incidence and surgeon experience, the aim of this study is to report a single institutional contemporary experience for outcomes of surgical treatment of EA by LHM and POEM, with regards to other comparable series in children...
October 2016: Journal of Pediatric Surgery
Reece K DeHaan, Daniel Davila, Matthew J Frelich, Jon C Gould
BACKGROUND: The goal of antireflux surgery is to create a competent antireflux valve at the esophagogastric junction (EGJ). The two most common types of fundoplications constructed are the 360° Nissen and the 270° Toupet. We sought to determine whether there was a significant difference in distensibility at the EGJ based on fundoplication geometry (full vs. partial). METHODS: This is a retrospective review of prospective data. All subjects underwent laparoscopic fundoplication over a 47-month period for primary GERD or failed fundoplication...
April 29, 2016: Surgical Endoscopy
Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Manuele Furnari, Salvatore Tolone, Giorgia Bodini, Valeria Bolognesi, Massimo Bellini, Vincenzo Savarino, Santino Marchi, Edoardo Vincenzo Savarino
Gastroesophageal reflux disease (GERD) is a common disorder of the gastrointestinal tract. In the last few decades, new technologies have evolved and have been applied to the functional study of the esophagus, allowing for the improvement of our knowledge of the pathophysiology of GERD. High-resolution manometry (HRM) permits greater understanding of the function of the esophagogastric junction and the risks associated with hiatal hernia. Moreover, HRM has been found to be more reproducible and sensitive than conventional water-perfused manometry to detect the presence of transient lower esophageal sphincter relaxation...
February 15, 2016: World Journal of Gastrointestinal Pathophysiology
W J Snape, M S Lin, N Agarwal, R E Shaw
BACKGROUND: Nausea and vomiting occurs in gastroparesis due to diabetes mellitus or unknown causes. The aim of this study was to compare (i) pyloric distensibility to pyloric manometric pressure in patients with nausea and vomiting and (ii) to correlate distensibility with delays in gastric emptying. METHODS: Sleeve manometry and EndoFLIP were performed sequentially during the same endoscopy on 114 patients with nausea and vomiting (47 with diabetes mellitus and 67 with idiopathic cause) after a standardized gastric emptying study...
May 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Reece K DeHaan, Matthew J Frelich, Jon C Gould
We sought to characterize the changes in esophagogastric junction (EGJ) distensibility during Heller Myotomy with Dor fundoplication using the EndoFLIP device. Intraoperative distensibility measurements on 14 patients undergoing Heller myotomy with Dor fundoplication were conducted over an 18-month period. Minimum esophageal diameter, cross-sectional areas, and distensibility index were measured at 30 and 40 mL catheter volumes before myotomy, postmyotomy, and following Dor fundoplication. Distensibility index is defined as the narrowest cross-sectional area divided by the corresponding pressure expressed in mm/mm Hg...
April 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Saowanee Ngamruengphong, Burkhard H A von Rahden, Jörg Filser, Amy Tyberg, Amit Desai, Reem Z Sharaiha, Arnon Lambroza, Vivek Kumbhari, Mohamad El Zein, Ahmed Abdelgelil, Sepideh Besharati, John O Clarke, Ellen M Stein, Anthony N Kalloo, Michel Kahaleh, Mouen A Khashab
BACKGROUND: Peroral endoscopic myotomy (POEM) has been introduced as an endoscopic alternative to surgical myotomy. The endoluminal functional lumen imaging probe (endoFLIP) evaluates esophagogastric junction (EGJ) distensibility based on cross-sectional area and pressure in response to volume distension. The aim of this study was to evaluate whether there is a correlation between endoFLIP measurements during POEM and postoperative clinical outcomes in terms of symptom relief and development of post-procedure reflux...
July 2016: Surgical Endoscopy
F G M Smeets, A A M Masclee, D Keszthelyi, E T T L Tjwa, J M Conchillo
BACKGROUND: Achalasia is characterized by a functional esophagogastric junction (EGJ) obstruction. The functional luminal imaging probe (EndoFLIP) is a method to assess EGJ distensibility. In a homogeneous group of newly diagnosed achalasia patients treated with pneumatic dilation (PD), we aimed (i) to determine whether the assessment of EGJ distensibility has added value in the management of achalasia patients and (ii) to evaluate whether EGJ distensibility differs between achalasia subtypes...
October 2015: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
C Lottrup, B P McMahon, P Ejstrud, M A Ostapiuk, P Funch-Jensen, A M Drewes
Hiatus hernia is known to be an important risk factor for developing gastroesophageal reflux disease. We aimed to use the endoscopic functional lumen imaging probe (EndoFLIP) to evaluate the functional properties of the esophagogastric junction. EndoFLIP assessments were made in 30 patients with hiatus hernia and Barrett's esophagus, and in 14 healthy controls. The EndoFLIP was placed straddling the esophagogastric junction and the bag distended stepwise to 50 mL. Cross-sectional areas of the bag and intra-bag pressures were recorded continuously...
July 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
A Ilczyszyn, K Hamaoui, J Cartwright, A Botha
Our study aimed to assess whether intraoperative esophagogastric junction (EGJ) distensibility measurement using the EndoFLIP EF325 catheter (Crospon Ltd., Galway, Ireland) could potentially be used to guide laparoscopic Heller's myotomy (LHM), potentially modifying the operation outcome and comparing this clinically to our previous technique of gastroscopic assessment. Following a full diagnostic assessment with manometry and endoscopy patients with achalasia were divided into two groups. A retrospective cohort of patients operated on between 2007 and 2010 had a gastroscopy-guided LHM (G-LHM) with a standardized myotomy of 8 cm on the esophagus and 3 cm on the stomach...
July 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Fabienne G M Smeets, Daniel Keszthelyi, Nicole D Bouvy, Ad A M Masclee, Jose M Conchillo
BACKGROUND/AIMS: In patients with gastroesophageal reflux disease (GERD), an increased esophagogastric junction (EGJ) distensibility has been described. Assessment of EGJ distensibility with the endoscopic functional luminal imaging probe (EndoFLIP) technique might identify patients responsive to transoral incisionless fundoplication (TIF), whereas postoperative measurement of EGJ distensibility might provide insight into the antireflux mechanism of TIF. Therefore, we investigated the value of the EndoFLIP technique in GERD patients treated by TIF...
March 30, 2015: Journal of Neurogastroenterology and Motility
Z Malik, A Sankineni, H P Parkman
BACKGROUND: Pyloric dysfunction has been associated with gastroparesis, particularly diabetic gastroparesis. Endoscopic functional luminal imaging probe (EndoFLIP) uses 16 sensors inside a balloon that is inflated inside a sphincter to assess physiologic characteristics. The aim of this study was to measure the pressure, diameter, cross-sectional area (CSA), and distensibility of the pylorus using EndoFLIP in patients with gastroparesis. In addition, the relationship between pyloric pathophysiology with gastroparesis etiology, symptoms, and gastric emptying was assessed...
April 2015: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Rakesh Kalapala, D Nageshwar Reddy, Mohan Ramchandani, Santosh Darisetty
No abstract text is available yet for this article.
May 2015: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
G Gourcerol, F Tissier, C Melchior, J Y Touchais, E Huet, G Prevost, A M Leroi, P Ducrotte
BACKGROUND: Pyloric pressure and compliance have never been investigated in health nor gastroparesis. AIM: We hypothesised that pyloric pressure and/or compliance may be altered in gastroparesis. METHODS: Fasting pyloric pressure and compliance were investigated in 21 healthy volunteers (HV), 27 gastroparetic patients (GP) and 5 patients who had undergone oesophagectomy without pyloroplasty as positive controls. Under videofluoroscopic control, pyloric compliance and pressure were measured by the EndoFLIP technique...
February 2015: Alimentary Pharmacology & Therapeutics
J Regan, M Walshe, C Timon, B P McMahon
OBJECTIVES: To evaluate safety of positioning and distending the functional lumen imaging probe in the pharyngo-oesophageal segment in adults with known pharyngo-oesophageal segment dysfunction and to obtain preliminary measurements of pharyngo-oesophageal segment distensibility and opening during swallowing in a clinical group. METHODS: Prospective case series of ten adults post total laryngectomy (61-75 years) recruited from an outpatient ENT clinic. Functional lumen imaging probe was inserted trans-nasally, and the balloon was positioned in the pharyngo-oesophageal segment...
April 2015: Clinical Otolaryngology
Pietro Familiari, Giovanni Gigante, Michele Marchese, Ivo Boskoski, Vincenzo Bove, Andrea Tringali, Vincenzo Perri, Graziano Onder, Guido Costamagna
BACKGROUND: Peroral endoscopic myotomy (POEM) has been recently introduced in clinical practice for the treatment of achalasia. The endoluminal functional lumen imaging probe (EndoFLIP) system) uses impedance planimetry for the real-time measurement of the diameter of the oesophago-gastric junction. OBJECTIVE: The aim of this study is to prospectively evaluate the effect of POEM on the oesophago-gastric junction using EndoFLIP. METHODS: All the patients who underwent POEM in a single centre between April and July 2013 were enrolled in the study...
April 2014: United European Gastroenterology Journal
Lene Hee, Donghua Liao, Puk Sandager, Hans Gregersen, Niels Uldbjerg
OBJECTIVE: To determine the stiffness of the pregnant uterine cervix in vivo. METHOD: Five women in early pregnancy and six women in late pregnancy were included. The EndoFlip is a 1-m-long probe with a 12-cm-long bag mounted on the tip. The tip of the probe was inserted into the cervical canal. Sensors spaced at 0.5-cm intervals along the probe were used to determine 16 serial cross-sectional areas of the bag. The diameter of the cervical canal could thereby be determined during inflation with up to 50 ml saline solution...
2014: PloS One
Silvana Perretta, Oliver McAnena, Abrie Botha, Leslie Nathanson, Lee Swanstrom, Nathaniel J Soper, Haruiro Inoue, Jeffrey Ponsky, Blair Jobe, Jacques Marescaux, Bernard Dallemagne
Laparoscopic fundoplication (LF) is a surgical treatment for gastroesophageal reflux disease (GERD) that has been performed for more than 20 years. High-volume centers of excellence report long-term success rates greater than 90% with LF. On the other hand, general population-based outcomes are reported to be markedly worse, leading to a nihilistic perception of the procedure on the part of the medical referral population. The lack of standardization of the technique and the lack of tools to calibrate objectively the repairs are probably among the causes of variability in the outcomes and may explain the decline in the number of LF procedures in recent years...
December 2013: Surgical Innovation
A Ilczyszyn, A J Botha
Increased esophagogastric junction distensibility has been implicated in the development of gastroesophageal reflux disease (GERD). Previous authors have demonstrated a reduction in distensibility following anti-reflux surgery, but the changes during the operation are not clear. Our study aimed to ascertain the feasibility of measuring intraoperative distensibility changes and to assess if this would have potential to modify the operation. Seventeen patients with GERD were managed in a standardized manner consisting of preoperative assessment with symptom scoring, endoscopy, 24 hours pH studies, and manometry...
September 2014: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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