ArticleSurgical endoscopy2022
Intraoperative diagnosis and treatment of Achalasia using EndoFLIP during Heller Myotomy and Dor fundoplication.
Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Development of expert consensus protocols for diagnostic and procedural use of the EndoFLIP system.Surgical endoscopy · 2026Article
- Pneumatic dilation, evaluation of compliance of esophagogastric junction by Pneumatic dilation balloon before POEM.Surgical endoscopy · 2026Article
- Esophageal Duplication Cyst: A Rare Cause of Esophagogastric Junction Obstruction.Annals of thoracic surgery short reports · 2026Article
- Subjective Assessment of the Pyloric Sphincter During Endoscopy and Its Correlation with FLIP Panometry.Digestive diseases and sciences · 2025Article
- Unlocking the secrets of esophageal motility: how ineffective motility influences dysphagia and LES function following robotic hiatal hernia repair.Surgical endoscopy · 2025Article
- Distensibility index measured after Toupet fundoplication is associated with long-term dysphagia.Surgical endoscopy · 2025Article
- Efficacy and outcomes of per oral plication of the (neo)esophagus (POPE) for impaired emptying in achalasia and post-esophagectomy patients.Surgical endoscopy · 2024Article
- A New Method to Evaluate Lower Esophageal Distension Capacity in Eosinophilic Esophagitis by Using Functional Lumen Imaging Probe (EndoFLIP™).Diagnostics (Basel, Switzerland) · 2024Article
- Endoluminal Functional Imaging Demonstrates Need for Myotomy During Epiphrenic Diverticulectomy.Annals of thoracic surgery short reports · 2023Article
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7 authors.
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Abstract
backgroundManometry is the gold standard diagnostic test for achalasia. However, there are incidences where manometry cannot be obtained preoperatively, or the results of manometry is inconsistent with the patient's symptomatology. We aim to determine if intraoperative use of EndoFLIP can provide a diagnosis of achalasia and provide objective information during Heller myotomy and Dor fundoplication.
methodsTo determine the intraoperative diagnostic EndoFLIP values for patients with achalasia, we determined the optimal cut-off points of the distensibility index (DI) between patients with a diagnosis of achalasia and patients with a diagnosis of hiatal hernia. To evaluate the usefulness of EndoFLIP values during Heller myotomy and Dor fundoplication, we obtained a cohort of patients with EndoFLIP values obtained after Heller myotomy and after Dor fundoplication as well as Eckardt score before and after surgery.
resultsOur analysis of 169 patients (133 hiatal hernia and 36 achalasia) showed that patients with DI < 0.8 have a >99% probability of having achalasia, while DI > 2.3 have a >99% probability of having hiatal hernia. Patients with a DI 0.8-1.3 have a 95% probability of having achalasia, and patients with a DI of 1.4-2.2 have a 94% probability of having a hiatal hernia. There were 40 patients in the cohort to determine objective data during Heller myotomy and Dor fundoplication. The DI increased from a median of 0.7 to 3.2 after myotomy and decreased to 2.2 after Dor fundoplication (p < 0.001). The median Eckardt score went down from a median of 4.5 to 0 (p < 0.001).
conclusionsOur study shows that intraoperative use of EndoFLIP can facilitate the diagnosis of achalasia and is used as an adjunct to diagnose achalasia when symptoms are inconsistent. The routine use of EndoFLIP during Heller myotomy and Dor fundoplication provides objective data during the operation in a group of patients with excellent short-term outcomes.
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