Tailored myotomy for the treatment of type 3 achalasia: Is there a role for the functional lumen imaging probe?

Article Gastroenterology & Hepatology

Diagnostic methods to measure spastic segment and guide tailored myotomy length in type 3 achalasia

Eric E. E. Low et al.

Summary: This study aimed to assess the agreement between different detection methods for the length of spastic segments in patients with type 3 achalasia. The results showed a good agreement between the lengths obtained from high-resolution manometry (HRM) and barium esophagram (BE), while there was a negative correlation and poor agreement when compared to endoscopic ultrasound (EUS). This suggests that HRM is more commonly used and the role of EUS in determining tailored myotomy length for type 3 achalasia is uncertain.

NEUROGASTROENTEROLOGY AND MOTILITY (2023)

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Letter Gastroenterology & Hepatology

Tailored myotomy length in peroral endoscopic myotomy for achalasia: Combination of high-resolution esophageal manometry and endoluminal functional lumen imaging probe

Kang Zou et al.

NEUROGASTROENTEROLOGY AND MOTILITY (2023)

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Article Gastroenterology & Hepatology

Myotomy technique and esophageal contractility impact blown-out myotomy formation in achalasia: an in silico investigation

Sourav Halder et al.

Summary: The length of myotomy, type of esophageal contractions, esophago-gastric junction tone, and muscle structure at the myotomy site all have an impact on esophageal wall stresses potentially leading to blown-out myotomy formation. Short myotomies decrease the chance of BOM formation, with propagated peristalsis having the highest risk and abnormal residual EGJ tone being a co-factor in BOM development.

AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY (2022)

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Article Gastroenterology & Hepatology

Blown-out myotomy: an adverse event of laparoscopic Heller myotomy and peroral endoscopic myotomy for achalasia

Joseph R. Triggs et al.

Summary: BOM is a common adverse event after myotomy for achalasia, associated with post-treatment symptom severity, achalasia type, and treatment modality. Pretreatment type III achalasia, LHM as opposed to POEM, and an increased post-treatment integrated relaxation pressure are risk factors for BOM development.

GASTROINTESTINAL ENDOSCOPY (2021)

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Article Gastroenterology & Hepatology

Achalasia subtypes can be identified with functional luminal imaging probe (FLIP) panometry using a supervised machine learning process

Dustin A. Carlson et al.

Summary: Using FLIP panometry and machine learning, a model was developed to predict and classify achalasia subtypes on HRM. The model can differentiate type III achalasia from non-spastic achalasia, with potential for clinical application.

NEUROGASTROENTEROLOGY AND MOTILITY (2021)

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Article Surgery

Intraoperative use of FLIP is associated with clinical success following POEM for achalasia

Amy L. Holmstrom et al.

Summary: The study suggests that intraoperative measurement of distensibility index (DI) using FLIP during per-oral endoscopic myotomy (POEM) is associated with improved clinical outcomes, potentially leading to a tailored myotomy for achalasia patients undergoing surgical interventions.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2021)

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Article Surgery

Using impedance planimetry (EndoFLIP™) in the operating room to assess gastroesophageal junction distensibility and predict patient outcomes following fundoplication

Bailey Su et al.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2020)

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Article Gastroenterology & Hepatology

Using Impedance Planimetry (EndoFLIP) to Evaluate Myotomy and Predict Outcomes After Surgery for Achalasia

Bailey Su et al.

JOURNAL OF GASTROINTESTINAL SURGERY (2020)

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Tailored myotomy for the treatment of type 3 achalasia: Is there a role for the functional lumen imaging probe?

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