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6 new papers utilizing EndoFLIP Technology published

7th July 2015

Five new papers and a review have been recently published which describe different uses of EndoFLIP technology.

The first paper Utilizing functional lumen imaging probe topography to evaluate esophageal contractility during volumetric distention: a pilot study by Carlson et al, offers an insight into forthcoming developments with EndoFLIP which will for the first time permit the assessment of motility disorders during endoscopy. This highly novel application, which is still in research, offers the possibility that initial endoscopy for patients with dysphagia, may utilize EndoFLIP not only for assessment of structural abnormalities in the esophagus or the gastroesophageal junction (GEJ), but for the first time, will also allow assessment of major motility disorders in a patient under conscious sedation. The second paper Long-term effects of anti-reflux surgery on the physiology of the esophagogastric junction by Kessing et al, presents data on the GEJ distensibility five or more years after fundoplication surgery. The authors conclude that surgical effects on GEJ physiology persist long term, with mean distensibility of 2.7 compared with 5.0 mm2/mmHg for similar group of GERD patients who did not receive fundoplication. A third paper Esophagogastric junction distensibility in hiatus hernia by Lottrup et al, provides an interesting insight into the relative contributions of the LES and the crural diaphragm in providing the mechanical barrier against retrograde reflux of gastric contents in patients with hiatus hernia. The authors demonstrate how the separated LES and crural diaphragm may be visualized using EndoFLIP. A fourth paper builds on previous work demonstrating the effect of myotomy length during POEM. The paper The effect of incremental distal gastric myotomy lengths on EGJ distensibility during POEM for achalasia by Teitelbaum et al, once more demonstrated that the submucosal tunnel alone provides a significant reduction in distensibility in the GEJ, and furthermore demonstrated the adequacy of a 2cm extension onto the gastric wall, with the effort of a 3cm extension being of little benefit in terms of improvement in distensibility. A fifth paper assesses the use of EndoFLIP to predict response to transoral GERD surgery. The paper Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease? by Smeets et al, found that distensibility was not found to be predictive. However the data offers an important possible insight into how distensibility measurements may be used to select the optimum patients for such transoral GERD surgery. In particular, they found that 94% of patients meeting both criteria of EGJ distensibility at 30 mL < 2.3 mm2/mmHg and acid exposure time < 11% had normalized acid exposure time at 6 months follow-up. Finally, a nonsystematic review on the use of FLIP technology in the GI tract has been published by Lottrup et al. The paper Functional Lumen imaging of the gastrointestinal tract provides a useful overview of FLIP technology and the history of its development.

The references for these five papers may be found below.

Utilizing functional lumen imaging probe topography to evaluate esophageal contractility during volumetricdistention: a pilot study
Carlson DA, Lin Z, Rogers MC, Lin CY, Kahrilas PJ, Pandolfino JE.
Neurogastroenterol Motil. 2015 Jul;27(7):981-9. doi: 10.1111/nmo.12572. Epub 2015 Apr 20.

Long-term effects of anti-reflux surgery on the physiology of the esophagogastric junction
Kessing BF, Bredenoord AJ, Schijven MP, van der Peet DL, van Berge Henegouwen MI, Smout AJ.
Surg Endosc. 2015 Mar 19. [Epub ahead of print]

Esophagogastric junction distensibility in hiatus hernia
Lottrup C, McMahon BP, Ejstrud P, Ostapiuk MA, Funch-Jensen P, Drewes AM.
Dis Esophagus. 2015 Mar 19. doi: 10.1111/dote.12344. [Epub ahead of print]

The effect of incremental distal gastric myotomy lengths on EGJ distensibility during POEM for achalasia
Teitelbaum EN, Sternbach JM, El Khoury R, Soper NJ, Pandolfino JE, Kahrilas PJ, Lin Z, Hungness ES.
Surg Endosc. 2015 Jun 20. [Epub ahead of print]

Functional lumen imaging of the gastrointestinal tract
Lottrup C, Gregersen H, Liao D, Fynne L, Frøkjær JB, Krogh K, Regan J, Kunwald P, McMahon BP.
J Gastroenterol. 2015 May 16. [Epub ahead of print]

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?
Smeets FG, Keszthelyi D, Bouvy ND, Masclee AA, Conchillo JM.
J Neurogastroenterol Motil. 2015 Mar 30;21(2):255-64. doi: 10.5056/jnm14111.

Measurement of Esophagogastric Junction Distensibility May Assist in Selecting Patients for Endoluminal Gastroesophageal Reflux Disease Surgery.
O Dea J.
J Neurogastroenterol Motil. 2015 Jul 30;21(3):448-9. doi: 10.5056/jnm15045.

Measurement of Esophagogastric Junction Distensibility May Assist in Selecting Patients for Endoluminal Gastroesophageal Reflux Disease Surgery: Author's Reply.
Smeets FG, Keszthelyi D, Masclee AA, Conchillo JM.
J Neurogastroenterol Motil. 2015 Jul 30;21(3):450-1. doi: 10.5056/jnm15101.

 
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