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[哥伦比亚波哥大圣伊格纳西奥大学医院腔内功能性管腔探头(EndoFLIP)的经验]

[Experience with endoluminal functional luminal probe (EndoFLIP) at San Ignacio University Hospital, Bogota, Colombia].

作者信息

Hani Albis, Ursida Valentina, Cañadas Raúl, Lombo Carlos, Figueredo María Del Carmen, Moreno Luna Socorro

机构信息

Hospital Universitario San Ignacio. Bogotá, Colombia; Pontificia Universidad Javeriana. Bogotá, Colombia.

Pontificia Universidad Javeriana. Bogotá, Colombia.

出版信息

Rev Gastroenterol Peru. 2024 Apr-Jun;44(2):110-116.

Abstract

INTRODUCTION

The EndoFLIP (for its acronym in English: endoluminal functional luminal probe) is a system that measures in real time the compliance index of the gastroesophageal junction and secondary esophageal peristalsis, based on the principle of impedance planimetry. Although this technology is relatively new and its diagnostic usefulness is still being evaluated, its use in clinical practice is increasingly recognized, fundamentally in those patients where there is no conclusive manometric diagnosis of esophageal motor pathology, mainly esophagogastric junction outflow obstruction and achalasia.

OBJECTIVE

The aim of the present study is to describe the experience with EndoFLIP at the San Ignacio University Hospital in Bogotá, Colombia.

MATERIAL AND METHODS

Descriptive observational case series study, which included patients over 18 years of age who had undergone EndoFLIP at the San Ignacio University Hospital from 2021 to 2022, either in-hospital or outpatient, with a clear indication of performance of the study, previously discussed in the multidisciplinary Gastroenterology Board.

RESULTS

A total of 27 patients with an average age of 55 years were included in the study, of which 20 were women (74%) and 7 men (26%). The most frequent indication of the study was an inconclusive diagnosis of outflow tract obstruction identified in high-resolution esophageal manometry according to Chicago 4.0 criteria (14 patients), followed by hypercontractile esophagus (4 patients) and ineffective esophageal motility (3 patients). When evaluating the contractile response, it was found that 9 patients with an inconclusive diagnosis of outflow tract obstruction had a normal response, 3 absent and one altered; and in the patients with an inconclusive diagnosis of achalasia, one of them had a borderline contractile response and two had no response. All patients with a previous diagnosis of absent contractility had an equally absent contractile response in EndoFLIP.

CONCLUSION

Endoluminal functional luminal imaging is a technique that evaluates biomechanical properties such as distensibility, volume, pressure and even diameters of sphincter regions such as the gastroesophageal junction, pylorus and anus. Its usefulness has been highlighted for several indications, the most important being manometrically inconclusive diagnoses of esophageal motor disorders such as achalasia and outflow tract obstruction, pathologies that have a significant impact on the quality of life of patients and whose diagnosis is essential to be able to provide the best treatment option.

摘要

引言

EndoFLIP(英文缩写,意为腔内功能性管腔探头)是一种基于阻抗平面测量原理实时测量胃食管交界处顺应性指数和食管继发性蠕动的系统。尽管这项技术相对较新,其诊断效用仍在评估中,但它在临床实践中的应用越来越得到认可,主要用于那些食管运动病理学测压诊断不明确的患者,主要是食管胃交界处流出道梗阻和贲门失弛缓症。

目的

本研究的目的是描述哥伦比亚波哥大圣伊格纳西奥大学医院使用EndoFLIP的经验。

材料与方法

描述性观察性病例系列研究,纳入2021年至2022年在圣伊格纳西奥大学医院接受EndoFLIP检查的18岁以上患者,包括住院患者和门诊患者,研究操作有明确指征,此前在多学科胃肠病学委员会进行过讨论。

结果

本研究共纳入27例患者,平均年龄55岁,其中女性20例(74%),男性7例(26%)。该研究最常见的指征是根据芝加哥4.0标准在高分辨率食管测压中确定的流出道梗阻诊断不明确(14例患者),其次是食管高收缩(4例患者)和食管动力无效(3例患者)。在评估收缩反应时,发现9例流出道梗阻诊断不明确的患者反应正常,3例无反应,1例异常;在贲门失弛缓症诊断不明确的患者中,其中1例收缩反应临界,2例无反应。所有先前诊断为无收缩力的患者在EndoFLIP检查中的收缩反应同样缺失。

结论

腔内功能性管腔成像技术可评估生物力学特性,如扩张性、容积、压力,甚至食管胃交界处、幽门和肛门等括约肌区域的直径。它在多种指征下的效用已得到凸显,最重要的是对食管运动障碍如贲门失弛缓症和流出道梗阻进行测压诊断不明确的情况,这些病症对患者生活质量有重大影响,其诊断对于能够提供最佳治疗方案至关重要。

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