背景:控制的径向扩张(CRE)球囊扩张器传统上用于在食管胃十二指肠镜检查(EGD)期间扩张食管狭窄。EndoFLIP是EGD期间用于测量胃肠腔的重要参数的诊断工具。能够评估扩张前后的治疗。EsoFLIP是将球囊扩张器与高分辨率阻抗平面测量相结合以在扩张期间实时提供一些管腔参数的相关装置。我们试图比较手术时间,透视时间,以及使用CRE球囊扩张联合EndoFLIP(E+CRE)与单独使用EsoFLIP的食管扩张的安全性。
方法:进行了单中心回顾性研究,以确定在2017年10月至2022年5月期间使用E+CRE或EsoFLIP进行EGD活检和食管狭窄扩张的年龄≤21岁的患者。
结果:23例患者(19例E+CRE和10例EsoFLIP)进行了29例EGDs伴食管狭窄扩张。两组在年龄上没有差异,性别,种族,首席投诉,食管狭窄类型,或既往胃肠道手术史(均p>0.05)。E+CRE和EsoFLIP组最常见的病史是嗜酸性粒细胞性食管炎和大疱性表皮松解症,分别。与E+CRE球囊扩张相比,EsoFLIP组的中位手术时间更短(EsoFLIP组40.5分钟[IQR23-57分钟];E+CRE组64分钟[IQR51-77分钟];p<0.01)。接受EsoFLIP治疗的患者的中位透视时间也较短(EsoFLIP扩张为0.16min[IQR0-0.30min];E+CRE组0.30min[IQR0.23-0.55];p=0.003)。两组均无并发症或计划外住院。
结论:在儿童中,与CRE球囊扩张联合EndoFLIP相比,食管狭窄的EsoFLIP扩张更快,需要更少的透视检查。同时同样安全。需要进行前瞻性研究以进一步比较这两种模式。
Controlled radial expansion (CRE) balloon dilators are traditionally used to dilate esophageal strictures during an esophagogastroduodenoscopy (EGD). EndoFLIP is a diagnostic tool used during an EGD to measure important parameters of the gastrointestinal lumen, capable of assessing treatment before and after dilation.
EsoFLIP is a related device that combines a balloon dilator with high-resolution impedance planimetry to provide some of the luminal parameters in real time during dilation. We sought to compare procedure time, fluoroscopy time, and safety profile of esophageal dilation using either CRE balloon dilation combined with EndoFLIP (E + CRE) versus EsoFLIP alone.
A single-center retrospective review was performed to identify patients ≤ 21 years of age who underwent an EGD with biopsy and esophageal stricture dilation using E + CRE or EsoFLIP between October 2017 and May 2022.
Twenty-nine EGDs with esophageal stricture dilation were performed in 23 patients (19 E + CRE and 10 EsoFLIP). The two groups did not differ in age, gender, race, chief complaint, type of esophageal stricture, or history of prior gastrointestinal procedures (all p > 0.05). The most common medical history in the E + CRE and EsoFLIP groups were eosinophilic esophagitis and epidermolysis bullosa, respectively. Median procedures times were shorter in the
EsoFLIP cohort compared to E + CRE balloon dilation (40.5 min [IQR 23-57 min] for the
EsoFLIP group; 64 min [IQR 51-77 min] for the E + CRE group; p < 0.01). Median fluoroscopy times were also shorter for patients who underwent
EsoFLIP (0.16 min [IQR 0-0.30 min] for
EsoFLIP dilation; 0.30 min [IQR 0.23-0.55] for the E + CRE group; p = 0.003). There were no complications or unplanned hospitalizations in either group.
EsoFLIP dilation of esophageal strictures was faster and required less fluoroscopy than CRE balloon dilation combined with EndoFLIP in children, while being equally as safe. Prospective studies are needed to further compare the two modalities.