4.6 Article

Impedance planimetry (EndoFLIP) measurements persist long term after anti-reflux surgery

Journal

SURGERY
Volume 171, Issue 3, Pages 628-634

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.surg.2021.08.065

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The functional lumen imaging probe provides objective measurements of the gastroesophageal junction during laparoscopic anti-reflux surgery. This study aimed to describe the changes in functional lumen imaging probe measurements during postoperative endoscopy and assess their long-term outcomes. The results showed that functional lumen imaging probe measurements after fundoplication were consistent over time, while patients who underwent magnetic sphincter augmentation had a tighter gastroesophageal junction.
Purpose: The functional lumen imaging probe provides objective measurements of the gastroesophageal junction during laparoscopic anti-reflux surgery. There is a lack of data on how functional lumen imaging probe measurements change at follow-up. We aim to describe our institutional experience in performing functional lumen imaging probe during postoperative endoscopy after laparoscopic anti-reflux surgery. Methods: A prospectively maintained database was queried. Patients who had postoperative endoscopic functional lumen imaging probe measurements between March 2018 and June 2021 were assessed at different time points from their index laparoscopic anti-reflux surgery using paired t test. Standardized quality of life questionnaires were collected for up to 2 years. Group comparisons were made using the Wilcoxon rank-sum test. Results: Fifty-eight patients who underwent laparoscopic anti-reflux surgery (magnetic sphincter augmentation or fundoplication) had postoperative functional lumen imaging probe. Thirty-two intra-operative functional lumen imaging probe values were compared with their postoperative functional lumen imaging probe. Fundoplication values did not differ. Postoperative functional lumen imaging probe distensibility index for magnetic sphincter augmentation patients was decreased (P = .04). Functional lumen imaging probe measurements for all postoperative endoscopies showed that magnetic sphincter augmentation had the lowest distensibility index (P < .01). Dysphagia as a reason for endos-copy had a decrease in distensibility index (P = .03). Conclusion: Functional lumen imaging probe measurements after fundoplication persist at long-term follow up while patients may have a tighter gastroesophageal junction after magnetic sphincter augmentation. Functional lumen imaging probe has the potential to assess the success or failure after laparoscopic anti-reflux surgery and optimize patient outcomes. (c) 2021 Elsevier Inc. All rights reserved.

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