Endoscopy 2018; 50(04): S46
DOI: 10.1055/s-0038-1637164
ESGE Days 2018 oral presentations
20.04.2018 – Motility disorders
Georg Thieme Verlag KG Stuttgart · New York

INTRAOPERATIVE USE OF FUNCTIONAL LUMEN IMAGING PROBE DURING PER-ORAL ENDOSCOPIC MYOTOMY IN PATIENTS WITH ACHALASIA

HJ Goong
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea, Republic of
,
JJ Hwang
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea, Republic of
,
BM Ko
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea, Republic of
,
SJ Hong
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea, Republic of
,
JW Kim
2   Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Department of Internal Medicine, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

The functional lumen imaging probe (EndoFLIP) is a recently developed technique to evaluate the function of esophagogastric junction (EGJ). Unlike timed barium esophagogram and high resolution manometry (HRM), EndoFLIP can be used during POEM. The aim of this study was to evaluate the feasibility of intraoperative measurements using EndoFLIP during POEM.

Methods:

From September 2014 to July 2017, 12 patients diagnosed with achalasia underwent POEM at a tertiary referral center. During POEM, the narrowest cross-sectional area (CSA), distensibility index (DI), and compliance (C) were measured by EndoFLIP before and after POEM. The results were compared with clinical outcomes at 3 months after POEM using Eckardt score, high resolution manometry, and timed barium esophagogram.

Results:

In 3 of 12 patients, postoperative measurement using EndoFLIP failed because the balloon pressure was lower than 5 mmHg. In 9 patients, POEM reduced CSA (Median [IQR], 21 [20 – 27] to 60 [71 – 92.5] mm2), DI (1.69 [1.21 – 3.11] to 9.55 [8.07 – 13.49] mm2/mm Hg), and C (55.60 [40.95 – 113.05] to 263 [194.4 – 313.1)] ml/mm Hg) at 30 ml balloon inflation. All of 9 patients showed good clinical response evaluated by Eckardt score (< 3). IRP on HRM was reduced (Mean ± SD, 32 ± 13.92 to 13 ± 7.58 mm Hg) after POEM. On timed-barium esophagogram, the heights of stasis decreased more than 50% in 8 patients.

Conclusions:

The EndoFLIP was successful in describing intraoperative changes of esophageal distensibility during POEM. All patients evaluated by their Eckardt score showed good clinical response.