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5 new papers utilizing EndoFLIP Technology published

17th November 2015

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

The first paper Hydraulic dilation with a shape-measuring balloon in idiopathic achalasia: a feasibility study by Kappelle et al, is the first published paper describing the human clinical use of the EsoFLIP achalasia dilation balloon with integrated measurement. The second paper, Esophagogastric junction distensibility in the management of achalasia patients: relation to treatment outcome by Smeets et al, assessed whether EndoFLIP measurements could predict responders to balloon dilation in achalasia patients. The authors concluded that a value of normal distensibility post-dilation was not predictive of a successful clinical outcome. A subsequent accepted letter concerning the paper discusses the fact that perhaps a higher than normal distensibility target ought to be targeted for a successful outcome. The third paper, Intraoperative measurement of esophagogastric junction cross-sectional area by impedance planimetry correlates with clinical outcomes of peroral endoscopic myotomy for achalasia: a multicenter study by Ngamruengphong S et al, is the second paper published this year which found that EndoFLIP measurements taken during achalasia surgery are predictive of clinical outcomes. Whereas in this case, cross sectional area was found to be predictive, and distensibility was not found to be a predictor at a level of clinical significance, it is nevertheless interesting to note that the range of distensibility at 40mL balloon volume, in those with a successful outcome, 5.95 (4.55–8.90), was markedly similar to the “ideal range” of 4.5-8.5 proposed by Teitelbaum et al. The fourth paper Endoscopic treatment for iatrogenic achalasia post-laparoscopic adjustable gastric banding by Pescarus et al, describes how pseudoachalasia, post-LAGB, after band removal, may be resolved using a POEM-like technique, with resolution verified by EndoFLIP measurements. Finally, a fifth paper The Functional Lumen Imaging Probe Detects Esophageal Contractility Not Observed With Manometry in Patients With Achalasia by Carlson et al, found that presentation of FLIP data in a new topographic fashion, “FLIP Topography”, not dissimilar to the pressure topography format displayed with high resolution manometry (HRM), allows esophageal contractility not observed with manometry to be detected in patients with achalasia. Figures 1 and 5 in this paper highlight the future potential for the fusion of structural and motility assessment in the esophagus during endoscopy.

The references for these five papers may be found below.

Hydraulic dilation with a shape-measuring balloon in idiopathic achalasia: a feasibility study
Kappelle WF, Bogte A, Siersema PD
Endoscopy. 2015 Nov;47(11):1028-34. doi: 10.1055/s-0034-1392481. Epub 2015 Sep 8

Esophagogastric junction distensibility in the management of achalasia patients: relation to treatment outcome
Smeets FG, Masclee AA, Keszthelyi D, Tjwa ET, Conchillo JM
Neurogastroenterol Motil. 2015 Oct;27(10):1495-503. doi: 10.1111/nmo.12651. Epub 2015 Aug 12

Dilation in Achalasia is normal distensibility enough? and Authors reply
O Dea J. and Smeets FG, Masclee AA, Keszthelyi D, Tjwa ET and Conchillo JM.
Neurogastroenterol Motil. 2016 Jan;28(1):153-5. doi: 10.1111/nmo.12707 / doi: 10.1111/nmo.12729

Intraoperative measurement of esophagogastric junction cross-sectional area by impedance planimetry correlates with clinical outcomes of peroral endoscopic myotomy for achalasia: a multicenter study
Ngamruengphong S, von Rahden BH, Filser J, Tyberg A, Desai A, Sharaiha RZ, Lambroza A, Kumbhari V, El Zein M, Abdelgelil A, Besharati S, Clarke JO, Stein EM, Kalloo AN, Kahaleh M, Khashab MA
Surg Endosc. 2015 Oct 20. [Epub ahead of print]

Endoscopic treatment for iatrogenic achalasia post-laparoscopic adjustable gastric banding
Pescarus R, Sharata A, Shlomovitz E, Reavis K, Dunst C, Swanstrom L
Surg Endosc. 2015 Oct 30. [Epub ahead of print]

The Functional Lumen Imaging Probe Detects Esophageal Contractility Not Observed With Manometry in Patients With Achalasia
Carlson DA, Lin Z, Kahrilas PJ, Sternbach J, Donnan EN, Friesen L, Listernick Z, Mogni B, Pandolfino JE.
Gastroenterology. 2015 Aug 14. pii: S0016-5085(15)01104-X. doi: 10.1053/j.gastro.2015.08.005. [Epub ahead of print]

 
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