背景:EndoFLIP(英文首字母缩写:腔内功能性管腔探头)是一种实时测量胃食管交界处的顺应性指数和继发性食管蠕动的系统,基于阻抗平面测量原理。尽管这项技术相对较新,其诊断实用性仍在评估中,它在临床实践中的使用越来越被认可,从根本上说,在那些没有确定的食管运动病理学测压诊断的患者中,主要为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在波哥大圣伊格纳西奥大学医院接受EndoFLIP的经历,哥伦比亚。
方法:描述性观察性案例系列研究,其中包括2021年至2022年在圣伊格纳西奥大学医院接受过EndoFLIP的18岁以上的患者,无论是住院还是门诊,清楚地表明了研究的表现,先前在多学科胃肠病学委员会中讨论过。
结果:共有27名平均年龄55岁的患者被纳入研究,其中20名女性(74%)和7名男性(26%)。该研究最常见的适应症是根据芝加哥4.0标准(14例)在高分辨率食管测压中发现的流出道梗阻的不确定诊断。其次是过度收缩食管(4例)和无效食管运动(3例)。当评估收缩反应时,结果发现,9例流出道梗阻诊断不确定的患者反应正常,3个缺失,1个改变;在门失弛缓症诊断不确定的患者中,其中一人有临界收缩反应,两人没有反应。先前诊断为缺乏收缩性的所有患者在EndoFLIP中的收缩反应都同样缺乏。
结论:腔内功能腔成像是一种评估生物力学特性的技术,例如扩张性,volume,压力,甚至括约肌区域的直径,如胃食管交界处,幽门和肛门.它的有用性已经得到了几个迹象的强调,最重要的是食管运动障碍如贲门失弛缓症和流出道梗阻的测压不确定诊断,对患者生活质量有重大影响的病理,其诊断对于能够提供最佳治疗选择至关重要。
BACKGROUND: 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.
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.
CONCLUSIONS: 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.