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阻抗平面测量(EndoFLIP)在抗反流手术后长期持续。

Impedance planimetry (EndoFLIP) measurements persist long term after anti-reflux surgery.

机构信息

Department of Surgery, NorthShore University Health System, Evanston, IL; Department of Surgery, University of Chicago Medical Center, Chicago, IL.

Department of Surgery, NorthShore University Health System, Evanston, IL; Department of Surgery, University of Chicago Medical Center, Chicago, IL.

出版信息

Surgery. 2022 Mar;171(3):628-634. doi: 10.1016/j.surg.2021.08.065. Epub 2021 Dec 2.

Abstract

PURPOSE

The functional lumen imaging probe provides objective measurements of the gastroesophageal junction during laparoscopic anti-reflux surgery. There is a lack of data on how functional lumen imaging probe measurements change at follow-up. We aim to describe our institutional experience in performing functional lumen imaging probe during postoperative endoscopy after laparoscopic anti-reflux surgery.

METHODS

A prospectively maintained database was queried. Patients who had postoperative endoscopic functional lumen imaging probe measurements between March 2018 and June 2021 were assessed at different time points from their index laparoscopic anti-reflux surgery using paired t test. Standardized quality of life questionnaires were collected for up to 2 years. Group comparisons were made using the Wilcoxon rank-sum test.

RESULTS

Fifty-eight patients who underwent laparoscopic anti-reflux surgery (magnetic sphincter augmentation or fundoplication) had postoperative functional lumen imaging probe. Thirty-two intraoperative functional lumen imaging probe values were compared with their postoperative functional lumen imaging probe. Fundoplication values did not differ. Postoperative functional lumen imaging probe distensibility index for magnetic sphincter augmentation patients was decreased (P = .04). Functional lumen imaging probe measurements for all postoperative endoscopies showed that magnetic sphincter augmentation had the lowest distensibility index (P < .01). Dysphagia as a reason for endoscopy had a decrease in distensibility index (P = .03).

CONCLUSION

Functional lumen imaging probe measurements after fundoplication persist at long-term follow up while patients may have a tighter gastroesophageal junction after magnetic sphincter augmentation. Functional lumen imaging probe has the potential to assess the success or failure after laparoscopic anti-reflux surgery and optimize patient outcomes.

摘要

目的

功能腔内腔成像探头可在腹腔镜抗反流手术中对胃食管交界处进行客观测量。目前缺乏关于功能腔内腔成像探头测量值在随访中如何变化的相关数据。我们旨在描述在腹腔镜抗反流手术后行内镜检查时使用功能腔内腔成像探头的机构经验。

方法

对前瞻性维护的数据库进行了查询。在 2018 年 3 月至 2021 年 6 月期间接受了术后内镜功能腔内腔成像探头测量的患者,在其腹腔镜抗反流手术的不同时间点进行了评估,使用配对 t 检验。收集了长达 2 年的标准化生活质量问卷。使用 Wilcoxon 秩和检验进行组间比较。

结果

58 例接受腹腔镜抗反流手术(磁括约肌增强或胃底折叠术)的患者进行了术后功能腔内腔成像探头检查。将 32 个术中功能腔内腔成像探头值与术后功能腔内腔成像探头值进行了比较。胃底折叠术值没有差异。磁括约肌增强患者的术后功能腔内腔成像探头扩张指数降低(P =.04)。所有术后内镜检查的功能腔内腔成像探头测量值均显示,磁括约肌增强患者的扩张指数最低(P <.01)。因吞咽困难而行内镜检查的患者,其扩张指数降低(P =.03)。

结论

胃底折叠术后功能腔内腔成像探头测量值在长期随访中持续存在,而磁括约肌增强后患者的胃食管交界处可能更紧。功能腔内腔成像探头有可能评估腹腔镜抗反流手术后的成功或失败,并优化患者的结果。

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