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Assessment of the esophagogastric junction (EGJ) using the EGJ contractile integral (EGJ-CI) following per-oral endoscopic myotomy (POEM) in achalasia 期刊论文

编号：

0bde1998-7c1a-49fb-bc86-b79214925ab6
作者：

Wang, Dan(王丹)#*^[1,2]Xu, Hong(徐红)^[1]Tang, Tongyu^[1];Wang, Jing(王晶)^[1]Yu, Yao^[1];Gyawali, C. Prakash^[2];
语种：

English
期刊：

REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS ISSN：1130-0108 2018 年 110 卷 11 期 (706 - 711)
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关键词：

Esophagogastric junction EGJ contractile integral High-resolution manometry Achalasia Per-oral endoscopic myotomy
摘要：

Background: the esophagogastric junction contractile integral (EGJ-CI) is a novel high-resolution manometry (HRM) tool designed to assess EGJ barrier function. This study assessed whether changes in EGJ-CI values reflect a disruption of the EGJ in achalasia patients undergoing per-oral endoscopic myotomy (POEM). Methods: patients with HRM performed both before and after POEM were identified over a three year period and were compared to healthy controls. EGJ-CI was calculated using the St Louis method, where EGJ vigor is assessed independently of respiration and referenced to the gastric baseline. It is reported as mmHg.cm . Pre- and post-POEM EGJ-CI, conventional lower esophageal sphincter pressure (LESP) metrics (end expiratory LESP and mean basal LESP) and integrated relaxation pressure (IRP) were compared between groups.The correlation between EGJ-CI and conventional LESP metrics was also assessed and compared to controls. Results: fifteen achalasia patients (35.2 +/- 2.5 years, 73% female) fulfilled the inclusion criteria and were compared to 20 healthy volunteers (26.6 +/- 1.1 years, 50% female).The Eckardt score was significant lower after POEM (1.5 +/- 0.3 vs 7.0 +/- 0.5, p < 0.001). Baseline conventional LESP metrics, EGJ-CI and IRP were higher in achalasia cases compared to controls (p <0.001). Both conventional LESP metrics and EGJ-CI decreased significantly following POEM (p < 0.001) and approximated the values recorded in controls (p >= 0.1). However, IRP remained higher post-POEM compared to controls (p = 0.011). EGJ-CI correlated with conventional LESP metrics at baseline (Pearson's r = 0.75-0.79; Spearman's rho = 0.84-0.85, p < 0.001) and following POEM (0.55-0.70 and 0.5-0.77, respectively; p s 0.03). Conclusions: EGJ-CI complements the assessment of the EGJ barrier and may be a useful metric to follow barrier function after per-oral myotomy.
推荐引用方式
GB/T 7714：

Wang Dan,Xu Hong,Tang Tongyu, et al. Assessment of the esophagogastric junction (EGJ) using the EGJ contractile integral (EGJ-CI) following per-oral endoscopic myotomy (POEM) in achalasia [J].REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS,2018,110(11):706-711.
APA：

Wang Dan,Xu Hong,Tang Tongyu,Wang Jing,&Gyawali C. Prakash.(2018).Assessment of the esophagogastric junction (EGJ) using the EGJ contractile integral (EGJ-CI) following per-oral endoscopic myotomy (POEM) in achalasia .REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS,110(11):706-711.
MLA：

Wang Dan, et al. "Assessment of the esophagogastric junction (EGJ) using the EGJ contractile integral (EGJ-CI) following per-oral endoscopic myotomy (POEM) in achalasia" .REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 110,11(2018):706-711.
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