ENDOSCOPIC PRESSURE STUDY INTEGRATED SYSTEM REFLECTS GASTROESOPHAGEAL JUNCTION COMPETENCE IN PATIENTS WITH EROSIVE ESOPHAGITIS AND BARRETT’S ESOPHAGUS

DOI
  • IWAYA Yugo
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • INOUE Haruhiro
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • de Santiago Enrique Rodríguez
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • Angeli Abad Mary Raina
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • FUJIYOSHI Yusuke
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • UENO Akiko
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • TANABE Mayo
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • SUMI Kazuya
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • TOMIDA Hideomi
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • OMINAMI Masaki
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • IKEDA Haruo
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • ONIMARU Manabu
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.
  • SHIMAMURA Yuto
    Digestive Diseases Center, Showa University Koto Toyosu Hospital, Showa University.

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Other Title
  • 内視鏡的内圧測定統合システム（EPSIS）は逆流性食道炎やバレット食道患者における胃食道接合部の機能を反映する

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Abstract

<p>Objectives: The endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool for gastroesophageal reflux disease (GERD) by monitoring intragastric pressure (IGP). Evaluation of the lower esophageal sphincter (LES) function may be achieved endoscopically by utilizing this newly developed diagnostic tool. This study aimed to evaluate the association between EPSIS results and gastroesophageal reflux-related diseases, e.g., erosive esophagitis (EE) and Barrett’s esophagus (BE).</p><p>Methods: This was a retrospective, single-center study. All patients who underwent EPSIS between November 2016 and July 2018 were included. EPSIS was performed during esophagogastroduodenoscopy with a dedicated electronic device and a through-the-scope catheter. The maximum IGP (IGP-max) and IGP waveform pattern (flat or uphill) were recorded with this system. Evaluation of an EE and BE was based on the Los Angeles classification and Prague classification, respectively.</p><p>Results: A total of 104 patients were enrolled; 29 (28％) had EE and 42 (40％) had BE. Patients with EE had lower IGP-max values (16.0 vs 18.8 mmHg, P＝0.01) and an EPSIS flat pattern was seen more frequently (82.8％ vs 37.3％, P < 0.001). Similarly, patients with BE displayed a lower IGP-max (15.7 vs 19.6 mmHg, P < 0.001) and presented with an EPSIS flat pattern in a higher proportion (69％ vs 37.1％, P < 0.001). These differences remained significant on multivariate analysis.</p><p>Conclusions: The EPSIS, as a novel diagnostic tool, was shown to exhibit a relation with EE and BE, implying that EPSIS is a promising modality to evaluate gastroesophageal refluxrelated diseases and LES function endoscopically.</p>

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