Sa1288 EFFECTIVENESS OF ENDOFLIP TOPOGRAPHY FOR EVALUATION OF ACHALASIA

Abstract

The functional lumen imaging probe (FLIP) provided luminal cross-sectional area (CSA) and pressure of esophagogastric junction (EGJ) during volumetric distension. Recently developed EndoFLIP topography shows a space-time-luminal diameter continuum using high-resolution impedence during volumetric distension. The aim of this study is to assess of efficacy of endoFLIP topography as diagnostic method of achalasia. Patients with suspected symptoms about achalasia were recruited and underwent EGD, high-resolution manometry (HRM), esophagography, and endoFLIP topography between January and July 2019. In HRM study, IRP≥20 mmHg were considered “abnormal”. FLIP studies were analyzed using a customized program to calculate the EGJ-distensibility index (DI) and generate FLIP topography plots to identify esophageal contractility patterns. FLIP topography was considered “abnormal” if EGJ-DI was <3.0 mm2/mmHg. A total of 110 patients were included and 23 out of 110 patients were diagnosed with achalasia through these studies. The values of IRP and DI of 110 patients were analysed and statistically showed a negative correlation (p<0.001). 13 out of 23 patients had abnormal DI with abnormal IRP and these topography showed all types of pattern (RAC, RRC, absent contractility and mixed contractility). There were 4 patients who had abnormal DI with normal IRP, and one patient’s topography showed absent contractiliy. The prediction rate of diagnosis of achalasia was increased by 4% when both values of IRP and DI were used (ROC curve; IRP:0.806, DI:0.801, IRP+DI:0.842). : EndoFLIP topography can be used as a complementary method for diagnosis and evaluation of achalasia. As using of DI and IRP results, prediction rate of diagnosis of achalasia was increased by 4% in this study. Further studies about diagnosis and evaluation of achalasia are neened.