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• W2978885792 abstract "Introduction: Symptomatic and radiographic outcomes following treatment for achalasia have inconsistently been associated with manometric measurements. Our aim was to assess novel highresolution impedance manometry (HRIM) parameters, the bolus flow time (BFT; a measure of esophageal emptying) and the esophageal impedance integral (EII) ratio (a measure of bolus retention), in addition to traditional HRM metrics, among achalasia patients following treatment with pneumatic dilation or myotomy. Methods: Patients with achalasia were evaluated prospectively during follow-up after intervention with symptom questionnaire [impaction-dysphagia questionnaire, IDQ, scored 0 (asymptomatic) - 50], HRIM, and timed-barium esophagram (TBE). HRIM studies were performed with catheters incorporating 36 pressure-sensors at 1-cm intervals and 18 impedance electrodes at 2-cm intervals and included ten 5-ml water swallows in the supine position. Study analysis included measurement of basal esophagogastic junction (EGJ) pressure at end-expiration, the integrated relaxation pressure (IRP), and use of a customized MATLAB program to calculate the BFT and EII ratios; median values for each patient were analyzed. Barium column height on TBE was measured 5 minutes after ingestion of 200 ml barium. Patients were analyzed in groups based on outcome assessment: Group 1 (good outcome): IDQ ≤ 6, TBE column height ≤5 cm; Group 2 (mixed): IDQ >6, TBE ≤5 cm or IDQ ≤6, TBE >5 cm; Group 3 (poor): IDQ >6, TBE > 5 cm. Groups were compared using nonparametric tests. Results: Follow-up evaluation was obtained in 44 patients [8 after pneumatic dilation, 12 after laparoscopic Heller myotomy, 24 after per-oral endoscopic myotomy (POEM)] at a median (range) of 13 (1 - 317) months. Groups 1, 2, and 3 included 14, 16, and 14 patients, respectively. Basal EGJ pressure (p = 0.89) and IRP (p = 0.18) did not differ between groups (Figure 1A and 1B). BFT and EII ratio differed between groups (p = 0.001 and p=0.03; Figures 1C and 1D); post-hoc testing demonstrated higher BFT (p = 0.001) and lower EII ratio (p = 0.009) in group 1 than group 3 patients. BFT was also higher in group 2 than group 3 (p = 0.012).Figure 1Conclusion: Novel HRIM parameters of BFT and EII ratio differed between achalasia groups defined by post-treatment radiographic and symptomatic outcomes. Incorporating the BFT and EII ratio into post-treatment follow-up evaluation may offer additive functional information to standard achalasia outcome assessment." @default.
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• W2978885792 date "2015-10-01" @default.
• W2978885792 modified "2023-09-27" @default.
• W2978885792 title "Assessment of Post-treatment Outcomes in Achalasia Utilizing Novel, High-Resolution Impedance Manometry Parameters: ACG Fellows-In-Training Award" @default.
• W2978885792 doi "https://doi.org/10.14309/00000434-201510001-01683" @default.
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