Argon Plasma Coagulation of Gastric Inlet Patches of the Cervical Esophagus Relieves Vocal and Respiratory Symptoms in Selected Patients

Brechmann, Thorsten; Mühlenkamp, M; Schmiegel, Wolff; Viebahn, Bernd

doi:10.1007/s10620-022-07745-9

Cited by 2 publications

(5 citation statements)

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“…Whilst these different studies point towards very similar proportions of patients improving after patch ablation, they use different methods to assess outcome and define symptoms differently. For example, Brechmann and colleagues measure “dysphonia” and “hoarseness” as two different symptoms when in fact they are the same 46 . We used the distributional approach to calculate MCID values.…”

Section: Discussionmentioning

confidence: 99%

“…Over 40% of patients required repeated treatments. They recorded the outcome of treatment using a single five‐point scale and reported that 73% of patients reported a “Very strong”, “Strong” or “Intermediate” improvement 46 . Klare and colleagues also used APC to treat 49 inlet patches.…”

Section: Discussionmentioning

confidence: 99%

“…They recorded the outcome of treatment using a single five-point scale and reported that 73% of patients reported a "Very strong", "Strong" or "Intermediate" improvement. 46 Klare and colleagues also used APC to treat 49 inlet patches. They recorded the outcome using Visual Analog Scales and reported treatment success in 73% of patients.…”

Section: Acid Exposure and The Mucosal Impedance Gradientmentioning

confidence: 99%

“…There was no such relationship between AEG and treatment response (Figure 5). Minor disorders of peristalsis 16 (46) Esophago-gastric junction outflow obstruction…”

Section: Associations Between Response To Apc and Measures Of Reflux ...mentioning

confidence: 99%

“…For example, Brechmann and colleagues measure "dysphonia" and "hoarseness" as two different symptoms when in fact they are the same. 46 We used the distributional approach to calculate MCID values. Although this enables an internally consistent approach that combines responses across different PROMs, we caution against generalizing values from the present series to the overall population of patients with gastric inlet patches.…”

Section: Acid Exposure and The Mucosal Impedance Gradientmentioning

confidence: 99%

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A multidisciplinary approach to identifying and managing heterotopic gastric inlet patches

Ayres,

Perring,

Nouraei

2024

Neurogastroenterology Motil

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IntroductionGastric inlet patches are often incidental, but can also be a treatable cause of laryngo‐esophageal symptoms.MethodsWe retrospectively reviewed all patients whose gastric inlet patches were diagnosed following assessment for laryngopharyngeal and swallowing symptoms. Improvement following Argon Plasma Coagulation (APC) was assessed using Minimum Clinically‐Important Difference methodology combining voice, throat, and swallowing domains. Correlations between APC response and measures of reflux and mucosal barrier integrity, measured during 24‐h pH‐impedance manometry, were obtained. Proximal and Distal Mean Nocturnal Baseline Impedance (MNBI) values were separately calculated and the novel variable of Mucosal Impedance Gradient was derived as [((Distal MNBI‐Proximal MNBI)/((Distal MNBI + Proximal MMBI)/2)) x 100].Key ResultsInlet patches were detected in 57 of 651 patients who had Transnasal Panendoscopy (8.7 ± 2.2%). There were 34 males. Mean age was 58 years. Mean duration of symptoms was 2 years. The commonest symptoms were hoarseness (n = 33), throat symptoms (n = 24), and dysphagia (n = 21), respectively. APC was used to ablate patches in 34 patients. Treatment response was 71% at a mean followup of 5.5 months. MIG > − 25% predicted response to APC, with area under the receiver operating characteristic curve of 0.875 (Sensitivity = 81%; Specificity = 100%; p < 0.0001).ConclusionsGastric inlet patches are common and under‐recognized. They can cause protracted pharyngo‐esophageal symptoms. Patch ablation is an effective treatment for carefully selected patients. Optimal patient selection requires multidisciplinary teamwork. Mucosal Impedance Gradient could further refine patient selection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Acid Exposure and The Mucosal Impedance Gradientmentioning

confidence: 99%

“…There was no such relationship between AEG and treatment response (Figure 5). Minor disorders of peristalsis 16 (46) Esophago-gastric junction outflow obstruction…”

Section: Associations Between Response To Apc and Measures Of Reflux ...mentioning

confidence: 99%

Section: Acid Exposure and The Mucosal Impedance Gradientmentioning

confidence: 99%

See 3 more Smart Citations