Esophageal motility classification can be established at the time of endoscopy: a study evaluating real-time functional luminal imaging probe panometry - 20/11/19
Abstract |
Background and Aims |
A novel device that provides real-time depiction of functional luminal image probe (FLIP) panometry (ie, esophagogastric junction [EGJ] distensibility and distension-induced contractility) was evaluated. We aimed to compare real-time FLIP panometry interpretation at the time of sedated endoscopy with high-resolution manometry (HRM) in evaluating esophageal motility.
Methods |
Forty consecutive patients (aged 24-81 years; 60% women) referred for endoscopy with a plan for future HRM from 2 centers were prospectively evaluated with real-time FLIP panometry during sedated upper endoscopy. The EGJ distensibility index and contractility profile were applied to derive a FLIP panometry classification at the time of endoscopy and again (post-hoc) using a customized program. HRM was classified according to the Chicago classification.
Results |
Real-time FLIP panometry motility classification was abnormal in 29 patients (73%), 19 (66%) of whom had a subsequent major motility disorder on HRM. All 9 patients with an HRM diagnosis of achalasia had abnormal real-time FLIP panometry classifications. Eleven patients (33%) had normal motility on real-time FLIP panometry and 8 (73%) had a subsequent HRM without a major motility disorder. There was excellent agreement (κ = .939) between real-time and post-hoc FLIP panometry interpretation of abnormal motility.
Conclusions |
This prospective, multicentered study demonstrated that real-time FLIP panometry could detect abnormal esophageal motility, including achalasia, at the endoscopic encounter. Additionally, normal motility on FLIP panometry was predictive of a benign HRM. Thus, real-time FLIP panometry incorporated with endoscopy appears to provide a suitable and well-tolerated point-of-care esophageal motility assessment.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : DDCR, DI, EGJ, EGJOO, FLIP, HRM, IRP, REO
Mappa
| DISCLOSURE: The following author received research support for this study from the Public Health Service (R01 DK079902 and P01 DK117824): J.E. Pandolfino. In addition, the following authors disclosed financial relationships relevant to this publication: D.A. Carlson, P.J. Kahrilas, Z. Lin, J.E. Pandolfino: Intellectual property rights and ownership surrounding FLIP panometry systems, methods, and apparatus with Medtronic. D.A. Carlson: Speaker and consultant for Medtronic. C. Prakash Gyawali: Speaker and consultant for Medtronic and Diversatek; consultant for Torax, Ironwood, and Quintiles. W. Kou: Consultant for Crospon, Inc. P.J. Kahrilas: Consultant for Ironwood. J.E. Pandolfino: Stockholder for Crospon, Inc; speaker and consultant for Given Imaging, Sandhill Scientific, Medtronic, and Torax; grant support from Given Imaging and Impleo; speaker for Takeda and Astra Zeneca; consultant for Ironwood. All other authors disclosed no financial relationships relevant to this publication. |
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| See CME section; p. 971. |
Vol 90 - N° 6
P. 915 - dicembre 2019 Ritorno al numero
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