학술논문
Endoscopic pressure study integrated system for the diagnosis of achalasia.
Document Type
Academic Journal
Author
Nishikawa Y; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Inoue H; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Shimamura Y; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Navarro MJ; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Institute of Digestive and Liver Diseases, St. Luke's Medical Center, Quezon City, Philippines.; Kawamata N; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Azuma D; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Ushikubo K; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Kimoto Y; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Yamamoto K; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Fujiyoshi Y; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Okada H; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Tanaka I; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Toshimori A; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Tanabe M; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.; Onimaru M; Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Source
Publisher: John Wiley & Sons Australia, Ltd Country of Publication: Australia NLM ID: 9101419 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1443-1661 (Electronic) Linking ISSN: 09155635 NLM ISO Abbreviation: Dig Endosc Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: The endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool used to evaluate lower esophageal sphincter (LES) function. EPSIS allows the measurement of intragastric pressure (IGP) during gastric insufflation through esophagogastroduodenoscopy (EGD) and records its pressure waveform. This study aimed to assess the usefulness and applicability of EPSIS as an adjunct diagnostic modality for achalasia.
Methods: This case-control study was conducted using a database of patients who underwent EGD, barium swallow (BS), high-resolution manometry (HRM), and EPSIS between January 2022 and December 2022. The achalasia (experimental) group (n = 35) consisted of patients with a definitive diagnosis of achalasia. The control group (n = 34) consisted of patients with no abnormalities in EGD, BS, or HRM and no abnormal acid reflux confirmed with 24-h pH-impedance monitoring. EPSIS findings were compared between the two groups and characterized by the waveform pattern (uphill or flat), maximum IGP (IGP-Max), pressure difference, and the gradient of the waveform.
Results: All patients in the achalasia group showed an uphill pattern, in contrast to 21 patients (61.8%) in the control group. IGP-Max demonstrated the best diagnostic accuracy for achalasia, with a cut-off value of 15.8 mmHg (100% sensitivity, 58.8% specificity, and area under the curve [AUC] 0.78). The pressure gradient also demonstrated good diagnostic accuracy, with a cut-off value of 0.40 mmHg/s (80% sensitivity, 61.8% specificity, and AUC 0.76).
Conclusion: This study demonstrated that EPSIS can be applied as a diagnostic modality in patients with achalasia.
(© 2023 Japan Gastroenterological Endoscopy Society.)
Methods: This case-control study was conducted using a database of patients who underwent EGD, barium swallow (BS), high-resolution manometry (HRM), and EPSIS between January 2022 and December 2022. The achalasia (experimental) group (n = 35) consisted of patients with a definitive diagnosis of achalasia. The control group (n = 34) consisted of patients with no abnormalities in EGD, BS, or HRM and no abnormal acid reflux confirmed with 24-h pH-impedance monitoring. EPSIS findings were compared between the two groups and characterized by the waveform pattern (uphill or flat), maximum IGP (IGP-Max), pressure difference, and the gradient of the waveform.
Results: All patients in the achalasia group showed an uphill pattern, in contrast to 21 patients (61.8%) in the control group. IGP-Max demonstrated the best diagnostic accuracy for achalasia, with a cut-off value of 15.8 mmHg (100% sensitivity, 58.8% specificity, and area under the curve [AUC] 0.78). The pressure gradient also demonstrated good diagnostic accuracy, with a cut-off value of 0.40 mmHg/s (80% sensitivity, 61.8% specificity, and AUC 0.76).
Conclusion: This study demonstrated that EPSIS can be applied as a diagnostic modality in patients with achalasia.
(© 2023 Japan Gastroenterological Endoscopy Society.)