Department of Surgery, NorthShore University Health System, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.
Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Surg Endosc. 2022 Feb;36(2):1536-1543. doi: 10.1007/s00464-021-08441-x. Epub 2021 Mar 19.
The endoluminal functional lumen imaging probe (FLIP) can be used to obtain real-time measurements of the diameter (D), cross-sectional area (CSA), and distensibility of the pylorus before and after peroral pyloromyotomy (POP), an emerging endoscopic treatment for delayed gastric emptying. Our study aims to report our single-center experience in performing POP with FLIP measurements before and after pyloromyotomy.
A retrospective review of a prospectively maintained gastroesophageal database was performed. Demographic and perioperative data, including intraoperative FLIP measurements of the pylorus before and after POP, were analyzed. Measurements were compared using paired t tests.
Thirty-four patients underwent POP between February 2017 and July 2020. Twenty-three (67.7%) patients were male and the average age was 59 years. The etiology of delayed gastric emptying was post-vagotomy in 22 patients, idiopathic gastroparesis in 7 patients, and diabetic gastroparesis in 5 patients. There were no significant differences in pre-myotomy or post-myotomy FLIP measurements when comparing the post-vagotomy versus the gastroparesis groups. There were significant increases in D, CSA, and distensibility index when comparing pre-myotomy and post-myotomy readings for all patients (all p < 0.001). At follow-up, 64.7% of patients reported resolution of all symptoms.
POP is an effective intervention in patients with delayed gastric emptying. Significant changes in FLIP measurements before and after POP suggest that FLIP may be a useful adjunct in guiding the management of delayed gastric emptying.
腔内功能管腔成像探头（FLIP）可用于在经口幽门肌切开术（POP）前后实时测量幽门的直径（D）、横截面积（CSA）和可扩张性，这是一种新兴的治疗胃排空延迟的内镜治疗方法。我们的研究旨在报告我们在经口幽门肌切开术中使用 FLIP 测量前后的单中心经验。
对前瞻性维护的胃食管数据库进行回顾性分析。分析人口统计学和围手术期数据，包括经口幽门肌切开术前后术中 FLIP 对幽门的测量。使用配对 t 检验比较测量值。
2017 年 2 月至 2020 年 7 月，34 例患者接受了 POP。23 例（67.7%）患者为男性，平均年龄为 59 岁。胃排空延迟的病因是 22 例胃手术后，7 例特发性胃轻瘫，5 例糖尿病性胃轻瘫。在比较胃手术后和胃轻瘫组时，前肌切开术或后肌切开术的 FLIP 测量值没有显著差异。所有患者的 D、CSA 和膨胀指数在比较前肌切开术和后肌切开术读数时均有显著增加（均 p<0.001）。随访时，64.7%的患者报告所有症状均已缓解。
POP 是治疗胃排空延迟患者的有效干预措施。POP 前后 FLIP 测量值的显著变化表明，FLIP 可能是指导胃排空延迟管理的有用辅助手段。
