Esophagogastric junction distensibility measurements during hydraulic dilation therapy in achalasia patients

Abstract

SUMMARYIncreasing evidence suggests that esophagogastric junction (EGJ) distensibility is predictive of long-term clinical success after achalasia treatment. A new commercially available hydraulic dilation balloon is capable of measuring EGJ opening diameters whilst simultaneously dilating the EGJ. Deployed alongside the endoscope under direct visualization, it is used for dilation of the lower esophageal sphincter in patients with achalasia. Impedance measurement electrodes are incorporated in the catheter shaft in the dilation balloon, which allows measuring the diameter of the EGJ and displaying it in real time before, during and after dilation. This obviates the need for fluoroscopy during the dilation procedure. The extent of recoil of the EGJ after dilation potentially provides a measurement that could be incorporated into a clinical rule for predicting therapeutic success after dilation. ARTICLE HISTORY

Use of the functional luminal imaging probe in pediatrics: A comparison study of patients with achalasia before and after endoscopic dilation and non‐achalasia controls

“…Dilations were performed using the Rigiflex pneumatic balloon system (Boston Scientific) based on modified New England Journal of Medicine (NEJM) guidelines 22 and the 30 mm EsoFLIP dilator catheter (Medtronic, Inc.) as previously described. [23][24][25] Pneumatic dilator sizes of 30, 35, or 40 mm were chosen based on each patient's clinical history and endoscopists' preference (Table S1). Pneumatic balloon dilation pressures ranged between 5 and 18 pounds per square inch (PSI).…”