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Delta-integrated relaxation pressures as a new high-resolution manometry metric to predict the positive outcome of laparoscopic Heller-Dor in patients with achalasia.
J Gastrointest Surg
February 2025
Unit of General Surgery 1, Department of Surgery, Oncology, and Gastroenterology, School of Medicine, University of Padova, Padova, Italy. Electronic address:
Background: There is no consensus on the definition of failure after treatment in patients with achalasia. The Eckardt score is used to define clinical outcomes. However, objective metrics are lacking.
View Article and Find Full Text PDFAGA Clinical Practice Update on Advances in Per-Oral Endoscopic Myotomy (POEM) and Remaining Questions-What We Have Learned in the Past Decade: Expert Review.
Gastroenterology
December 2024
Baylor Scott and White Center for Esophageal Diseases, Baylor University Medical Center, Dallas, Texas.
Description: This American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) aims to review the available evidence and provide expert advice regarding advances in per-oral endoscopic myotomy (POEM).
Methods: This CPU was commissioned and approved by the AGA Institute CPU Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPU Committee and external peer review through standard procedures of Gastroenterology. This review is framed around best practice advice points agreed upon by the authors, based on the current available evidence and expert opinion in this field.
[Experience with endoluminal functional luminal probe (EndoFLIP) at San Ignacio University Hospital, Bogota, Colombia].
Rev Gastroenterol Peru
July 2024
Pontificia Universidad Javeriana. Bogotá, Colombia.
Article Synopsis
- The EndoFLIP is a new diagnostic system that evaluates esophageal function in real time, especially beneficial for patients with unclear esophageal motor issues like outflow obstruction and achalasia.
- The study at San Ignacio University Hospital involved 27 patients, primarily women, all over 18, and focused on cases with inconclusive prior diagnoses.
- Results showed varied contractile responses in patients, revealing that many had normal or absent responses, which helps in understanding their individual esophageal conditions.
Esophagogastric Junction Outflow Obstruction (EGJOO): A Manometric Phenomenon or Clinically Impactful Problem.
Curr Gastroenterol Rep
July 2024
Mayo Clinic Arizona, 13400 E. Shea Blvd, Scottsdale, AZ, USA.
Purpose Of Review: Esophagogastric junction outflow obstruction (EGJOO), defined manometrically by impaired esophagogastric junction relaxation (EGJ) with preserved peristalsis, can be artifactual, due to secondary etiologies (mechanical, medication-induced), or a true motility disorder. The purpose of this review is to go over the evolving approach to diagnosing and treating clinically relevant EGJOO.
Recent Findings: Timed barium esophagram (TBE) and the functional lumen imaging probe (FLIP) are useful to identify clinically relevant EGJOO that merits lower esophageal sphincter (LES) directed therapies.
The Milan score: A novel manometric tool for a more efficient diagnosis of gastro-esophageal reflux disease.
United European Gastroenterol J
June 2024
Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA.
Objective: A definitive diagnosis of gastroesophageal reflux disease (GERD) depends on endoscopic and/or pH-study criteria. However, high resolution manometry (HRM) can identify factors predicting GERD, such as ineffective esophageal motility (IEM), esophago-gastric junction contractile integral (EGJ-CI), evaluating esophagogastric junction (EGJ) type and straight leg raise (SLR) maneuver response. We aimed to build and externally validate a manometric score (Milan Score) to stratify the risk and severity of the disease in patients undergoing HRM for suspected GERD.
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