Division of Gastroenterology, Center for Esophageal Diseases, Baylor University Medical Center, Baylor Scott & White, Dallas, Texas, USA.
Curr Opin Gastroenterol. 2022 Jul 1;38(4):388-394. doi: 10.1097/MOG.0000000000000843.
Esophagogastric junction outflow obstruction (EGJOO) comprises a heterogeneous group of conditions that demonstrate impaired deglutitive relaxation of the esophagogastric junction (EGJ) with intact esophageal peristalsis on high-resolution manometry. Functional luminal imaging probe (FLIP) panometry is a powerful tool that can help to clarify the etiology of this manometric diagnosis. The aim of this review is to summarize the use of FLIP for the evaluation and management of EGJOO.
FLIP panometry provides measures of esophageal compliance at the EGJ and information on esophageal body contractile responses to balloon distention that have important implications for the management of patients with EGJOO. After excluding anatomic causes of impaired EGJ distensibility, FLIP panometry is useful in differentiating true lower esophageal sphincter dysfunction from manometric artifact. FLIP panometry has been shown to be useful in determining the need for invasive treatment in patients with EGJOO, and in intraoperative tailoring of myotomy procedures.
FLIP panometry is easy to perform during endoscopy and provides useful information for characterizing the EGJOO population. FLIP panometry can be used to guide treatment and improve outcomes in the management of patients with EGJOO.
食管胃结合部流出梗阻(EGJOO)由一组表现为吞咽时食管胃结合部(EGJ)松弛障碍但食管蠕动正常的异质性疾病组成,高分辨率测压可明确这一诊断。功能腔内成像探头(FLIP)测压是一种强大的工具,可以帮助明确这一测压诊断的病因。本文旨在总结 FLIP 在 EGJOO 评估和管理中的应用。
FLIP 测压可提供 EGJ 食管顺应性的测量指标,并可提供食管体收缩对球囊扩张反应的信息,这对 EGJOO 患者的管理具有重要意义。在排除 EGJ 扩张障碍的解剖原因后,FLIP 测压有助于鉴别真正的食管下括约肌功能障碍与测压伪影。FLIP 测压有助于确定 EGJOO 患者是否需要侵入性治疗,并有助于术中调整肌切开术。
FLIP 测压在进行内镜检查时易于操作,可为 EGJOO 人群的特征提供有用的信息。FLIP 测压可用于指导治疗,改善 EGJOO 患者的管理结局。