The Gastroesophageal Flap Valve

Hill, Lucius D.; Kozarek, Richard A.

doi:10.1097/00004836-199904000-00002

Cited by 66 publications

(71 citation statements)

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“…Six months after TIF, GERD symptoms had improved according to the reduction in GERD-HRQL scores (from 26 [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]) to 10 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], P < 0.01). Common use of acid suppressive medication was discontinued by 67% of patients, whereas 19% used PPIs occasionally and common use was present in 14%.…”

Section: Patient Characteristics and Symptom Scoresmentioning

confidence: 99%

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

Smeets

Keszthelyi

Bouvy

et al. 2015

J Neurogastroenterol Motil

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Background/Aims In patients with gastroesophageal reflux disease (GERD), an increased esophagogastric junction (EGJ) distensibility has been described. Assessment of EGJ distensibility with the endoscopic functional luminal imaging probe (EndoFLIP) technique might identify patients responsive to transoral incisionless fundoplication (TIF), whereas postoperative measurement of EGJ distensibility might provide insight into the antireflux mechanism of TIF. Therefore, we investigated the value of the EndoFLIP technique in GERD patients treated by TIF. Methods Forty-two GERD patients underwent EGJ distensibility measurement before TIF using the EndoFLIP technique. In a subgroup of 25 patients, EndoFLIP measurement was repeated both postoperative and at 6 months follow-up. Treatment outcome was assessed according to esophageal acid exposure time (AET; objective outcome) and symptom scores (clinical outcome) 6 months after TIF. Results Multiple logistic regression analysis showed that preoperative EGJ distensibility (OR, 0.16; 95% CI, 0.03–0.78; P = 0.023) and preoperative AET (OR, 0.62; 95% CI, 0.42–0.90; P = 0.013) were independent predictors for objective treatment outcome but not for clinical outcome after TIF. The best cut-off value for objective outcome was 2.3 mm 2 /mmHg for preoperative EGJ distensibility and 11% for preoperative AET. EGJ distensibility decreased direct postoperative from 2.0 (1.2–3.3) to 1.4 (1.0–2.2) mm 2 /mmHg ( P = 0.014), but increased to 2.2 (1.5–3.0) at 6 months follow-up ( P = 0.925, compared to preoperative). Conclusions Preoperative EGJ distensibility and preoperative AET were independent predictors for objective treatment outcome but not for clinical outcome after TIF. According to our data, the EndoFLIP technique has no added value either in the preoperative diagnostic work-up or in the post-procedure evaluation of endoluminal antireflux therapy.

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Section: Patient Characteristics and Symptom Scoresmentioning

confidence: 99%

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

Smeets

Keszthelyi

Bouvy

et al. 2015

J Neurogastroenterol Motil

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“…The geometry of the gastroesophageal valve was investigated by measuring the Jobe length, defined as the distance (in centimeters) from the apex of the fundus to the valve lip [17,18], using standard biopsy forceps with open valves (4 mm wide), and the Hill grade [19], as follows:…”

Section: Geometric Aspects Of the Gastroesophageal Valvementioning

confidence: 99%

Transoral incisionless fundoplication (TIF 2.0) with EsophyX for gastroesophageal reflux disease: long-term results and findings affecting outcome

et al. 2011

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“…30 The Hill grade is used to assess the gastroesophageal flap valve geometry, 31 and EndoFLIP can be an useful adjunct. Kwiatek and colleagues showed an increase in EGJ distensibility of up to 3-fold in GERD patients compared to controls.…”

Section: 29mentioning

confidence: 99%

Emerging Roles of the Endolumenal Functional Lumen Imaging Probe in Gastrointestinal Motility Disorders

Ata-Lawenko

Lee

2017

J Neurogastroenterol Motil

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Gastrointestinal sphincters play a vital role in gut function and motility by separating the gut into functional segments. Traditionally, function of sphincters including the esophagogastric junction is studied using endoscopy and manometry. However, due to its dynamic biomechanical properties, data on distensibility and compliance may provide a more accurate representation of the sphincter function. The endolumenal functional lumen imaging probe (EndoFLIP) system uses a multi-detector impedance planimetry system to provide data on tissue distensibility and geometric changes in the sphincter as measured through resistance to volumetric distention with real-time images. With the advent of EndoFLIP studies, esophagogastric junction dysfunction and other disorders of the stomach and bowels may be better evaluated. It may be utilized as a tool in predicting effectiveness of endoscopic and surgical treatments as well as patient outcomes.

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The Gastroesophageal Flap Valve

Cited by 66 publications

References 0 publications

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

Transoral incisionless fundoplication (TIF 2.0) with EsophyX for gastroesophageal reflux disease: long-term results and findings affecting outcome

Emerging Roles of the Endolumenal Functional Lumen Imaging Probe in Gastrointestinal Motility Disorders

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