Role of endoscopic functional luminal imaging probe in predicting the outcome of gastric peroral endoscopic pyloromyotomy (with video)

Kia Vosoughi, Yervant Ichkhanian, Jérémie Jacques, A. Aziz Aadam, Petros C. Benias, Ryan Law, William L. Hasler, Andrew Canakis, Olivier Ragi, Joseph Triggs, Nicole Bowers, Olaya I. Brewer Gutierrez, Vivek Kumbhari, Anthony N. Kalloo, Robert S. Bulat, John E. Pandolfino, Mouen A. Khashab*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background and Aims: Endoluminal functional luminal imaging probe (EndoFLIP) is an imaging tool that measures the physiologic characteristics of GI sphincters. In this study, we used EndoFLIP to evaluate the association between the pyloric physiologic measurements and the clinical outcomes of gastric peroral endoscopic myotomy (G-POEM) in patients with refractory gastroparesis. Methods: Thirty-seven patients from 5 centers who underwent G-POEM for management of refractory gastroparesis and had EndoFLIP measurements were evaluated. Cross-sectional area (CSA), balloon pressure, and the distensibility index (DI) of the pylorus were evaluated by EndoFLIP at 40 mL and 50 mL balloon fills before and after G-POEM. One-year clinical success and change in gastric emptying study 3 months after the G-POEM procedure were compared with the EndoFLIP measurements. Results: Clinical success was achieved in 26 (70%) patients. Post–G-POEM CSA and DI were significantly higher in the clinical success group with both 40-mL volume distension (CSA: 89.9 ± 64.8 vs 172.5 ± 71.9 mm2, P =.003; DI: 5.8 ± 4.4 vs 8.8 ± 6.1 mm2/mm Hg, P =.043) and 50-mL volume distention (CSA: 140.1 ± 89.9 vs 237.5 ± 80.3 mm2, P =.003; DI: 5.6 ± 3.3 vs 9.9 ± 6.6 mm2/mm Hg, P =.049). CSA using 40-mL volume distention with an area under the curve of 0.83 yielded a specificity of 91% and a sensitivity of 71% at a cutoff point of 154 mm2. Conclusions: Post–G-POEM CSA of the pylorus is associated with clinical success and improvement in a gastric emptying scan after G-POEM. EndoFLIP measurements of the pylorus have the potential to be used as a tool to predict the clinical outcome of G-POEM.

Original languageEnglish (US)
Pages (from-to)1289-1299
Number of pages11
JournalGastrointestinal endoscopy
Volume91
Issue number6
DOIs
StatePublished - Jun 2020

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Fingerprint Dive into the research topics of 'Role of endoscopic functional luminal imaging probe in predicting the outcome of gastric peroral endoscopic pyloromyotomy (with video)'. Together they form a unique fingerprint.

  • Cite this

    Vosoughi, K., Ichkhanian, Y., Jacques, J., Aadam, A. A., Benias, P. C., Law, R., Hasler, W. L., Canakis, A., Ragi, O., Triggs, J., Bowers, N., Brewer Gutierrez, O. I., Kumbhari, V., Kalloo, A. N., Bulat, R. S., Pandolfino, J. E., & Khashab, M. A. (2020). Role of endoscopic functional luminal imaging probe in predicting the outcome of gastric peroral endoscopic pyloromyotomy (with video). Gastrointestinal endoscopy, 91(6), 1289-1299. https://doi.org/10.1016/j.gie.2020.01.044