Abstract：
OBJECTIVE: The endoscopic pressure study integrated system (EPSIS) is an endoscopic diagnostic system utilized for evaluation of lower esophageal sphincter function. Although previous studies have determined that EPSIS was effective as a tool for the diagnosis of achalasia, it remains uncertain if EPSIS can detect significant changes before and after peroral endoscopic myotomy (POEM), which is the premier treatment for achalasia. This study aimed to evaluate the effectiveness of EPSIS as an objective diagnostic tool for assessing the clinical effect of POEM.
METHODS: We conducted a retrospective analysis of patients who underwent POEM from January 2022 to December 2023. The patients underwent EPSIS preoperatively and 2 months postoperatively. Intragastric pressure (IGP) parameters, including the maximum IGP, IGP difference, and waveform gradient were compared pre- and post-POEM. These parameters also were compared between two groups: the postoperative gastroesophageal reflux disease (GERD) group and the non-GERD group.
RESULTS: A total of 50 patients were analyzed. The mean maximum IGP was significantly lower postoperatively than preoperatively (15.0 mmHg vs. 19.8 mmHg, P < 0.001). The mean IGP difference and waveform gradient were also significantly lower postoperatively than preoperatively (8.0 mmHg vs. 12.2 mmHg, P < 0.001; and 0.26 mmHg/s vs. 0.43 mmHg/s, P < 0.001, respectively). The mean postoperative waveform gradient was significantly lower in the GERD group (17 patients, 34%) than in the non-GERD group (33 patients, 66%) (0.207 mmHg vs. 0.291 mmHg, P = 0.034).
CONCLUSIONS: The results supported the use of EPSIS as an effective diagnostic tool for assessing the effect of POEM.
METHODS: We conducted a retrospective analysis of patients who underwent POEM from January 2022 to December 2023. The patients underwent EPSIS preoperatively and 2 months postoperatively. Intragastric pressure (IGP) parameters, including the maximum IGP, IGP difference, and waveform gradient were compared pre- and post-POEM. These parameters also were compared between two groups: the postoperative gastroesophageal reflux disease (GERD) group and the non-GERD group.
RESULTS: A total of 50 patients were analyzed. The mean maximum IGP was significantly lower postoperatively than preoperatively (15.0 mmHg vs. 19.8 mmHg, P < 0.001). The mean IGP difference and waveform gradient were also significantly lower postoperatively than preoperatively (8.0 mmHg vs. 12.2 mmHg, P < 0.001; and 0.26 mmHg/s vs. 0.43 mmHg/s, P < 0.001, respectively). The mean postoperative waveform gradient was significantly lower in the GERD group (17 patients, 34%) than in the non-GERD group (33 patients, 66%) (0.207 mmHg vs. 0.291 mmHg, P = 0.034).
CONCLUSIONS: The results supported the use of EPSIS as an effective diagnostic tool for assessing the effect of POEM.
摘要：
目的：内镜压力研究集成系统（EPSIS）是一种用于评估食管下括约肌功能的内镜诊断系统。尽管以前的研究已经确定EPSIS作为诊断门失弛缓症的工具是有效的，尚不确定EPSIS是否可以在经口内镜肌切开术（POEM）之前和之后检测到明显的变化，这是贲门失弛缓症的首要治疗方法。本研究旨在评估EPSIS作为评估POEM临床效果的客观诊断工具的有效性。
方法：我们对2022年1月至2023年12月接受POEM的患者进行了回顾性分析。患者术前和术后2个月接受EPSIS。胃内压力(IGP)参数,包括最大IGP,IGP差异,比较了POEM前后的波形梯度。这些参数也在两组之间进行了比较：术后胃食管反流病（GERD）组和非GERD组。
结果：共50例患者被分析。术后平均最大IGP显著低于术前(15.0mmHgvs.19.8mmHg,P<0.001)。术后平均IGP差异和波形梯度也显著低于术前(8.0mmHgvs.12.2mmHg,P<0.001；和0.26mmHg/svs.0.43mmHg/s,分别为P<0.001)。GERD组术后平均波形梯度显著降低(17例,34%)高于非GERD组(33例,66％）（0.207mmHg与0.291mmHg,P=0.034)。
结论：结果支持使用EPSIS作为评估POEM效果的有效诊断工具。
方法：我们对2022年1月至2023年12月接受POEM的患者进行了回顾性分析。患者术前和术后2个月接受EPSIS。胃内压力(IGP)参数,包括最大IGP,IGP差异,比较了POEM前后的波形梯度。这些参数也在两组之间进行了比较：术后胃食管反流病（GERD）组和非GERD组。
结果：共50例患者被分析。术后平均最大IGP显著低于术前(15.0mmHgvs.19.8mmHg,P<0.001)。术后平均IGP差异和波形梯度也显著低于术前(8.0mmHgvs.12.2mmHg,P<0.001；和0.26mmHg/svs.0.43mmHg/s,分别为P<0.001)。GERD组术后平均波形梯度显著降低(17例,34%)高于非GERD组(33例,66％）（0.207mmHg与0.291mmHg,P=0.034)。
结论：结果支持使用EPSIS作为评估POEM效果的有效诊断工具。
