Abstract:
Esophageal manometry is utilized for the evaluation and classification of esophageal motility disorders. EndoFlip has been introduced as an adjunctive test to evaluate esophagogastric junction (EGJ) distensibility. Treatment options for achalasia and EGJ outflow obstruction (EGJOO) include pneumatic dilation, myotomy, and botulinum toxin. Recently, a therapeutic 30 mm hydrostatic balloon dilator (EsoFLIP, Medtronic, Minneapolis, MN, USA) has been introduced, which uses impedance planimetry technology like EndoFlip. We performed a systematic review to evaluate the safety and efficacy of EsoFLIP in the management of esophageal motility disorders. A systematic literature search was performed with Medline, Embase, Web of science, and Cochrane library databases from inception to November 2022 to identify studies utilizing EsoFLIP for management of esophageal motility disorders. Our primary outcome was clinical success, and secondary outcomes were adverse events. Eight observational studies including 222 patients met inclusion criteria. Diagnoses included achalasia (158), EGJOO (48), post-reflux surgery dysphagia (8), and achalasia-like disorder (8). All studies used 30 mm maximum balloon dilation except one which used 25 mm. The clinical success rate was 68.7%. Follow-up duration ranged from 1 week to a mean of 5.7 months. Perforation or tear occurred in four patients. EsoFLIP is a new therapeutic option for the management of achalasia and EGJOO and appears to be effective and safe. Future comparative studies with other therapeutic modalities are needed to understand its role in the management of esophageal motility disorders.
摘要:
食管测压用于评估和分类食管运动性疾病。EndoFlip已被引入作为评估食管胃结合部(EGJ)扩张性的辅助测试。贲门失弛缓症和EGJ流出道梗阻(EGJOO)的治疗方案包括气动扩张术,肌切开术,和肉毒杆菌毒素.最近,治疗性30毫米静水球囊扩张器(EsoFLIP,美敦力,明尼阿波利斯,MN,美国)已被引入,它使用阻抗平面技术,如EndoFlip。我们进行了系统评价,以评估EsoFLIP在食管运动障碍治疗中的安全性和有效性。使用Medline进行了系统的文献检索,Embase,WebofScience,和Cochrane图书馆数据库从开始到2022年11月,以确定利用EsoFLIP管理食管运动障碍的研究。我们的主要结果是临床成功,次要结局是不良事件.包括222名患者在内的8项观察性研究符合纳入标准。诊断包括贲门失弛缓症(158),EGJOO(48),反流手术后吞咽困难(8),和贲门失弛缓症(8)。所有研究均使用30毫米最大球囊扩张,但其中一项使用25毫米。临床成功率为68.7%。随访时间为1周至平均5.7个月。四名患者发生穿孔或撕裂。EsoFLIP是一种治疗贲门失弛缓症和EGJOO的新治疗选择,似乎是有效和安全的。需要与其他治疗方式进行未来的比较研究,以了解其在食管运动障碍治疗中的作用。