P0433 - Endoscopic Functional Luminal Imaging Probe as a Screening Tool for Esophageal Disorders: A Single Center Experience

Jose V. Camilion, BA¹, Ernesto Robalino Gonzaga, MD², Gala Godoy Brewer, MD³, Robert S. Bulat, MD⁴, Tsion Abdi, MD⁵, Olaya I. Brewer, MD^6
1Nova Southeastern University, Miami, FL; ²AdventHealth, Orlando, FL; ³University of Miami/Jackson Memorial Hospital, Miami, FL; ⁴Johns Hopkins Hospital, Baltimore, MD; ⁵Johns Hopkins Hospital, Columbia, MD; ⁶Johns Hopkins Hospital, Sibley Memorial Hospital, Washington, DC

Introduction: High Resolution Esophageal Manometry (HREM) is the gold standard for the diagnosis of esophageal motility disorders, but with certain limitations. The Endoscopic Functional Luminal Probe (EndoFLIP) is a tool for assessment of esophagogastric junction distensibility (EGJ DI), cross-sectional area (CSA), pressure, diameter and contraction patterns which can help to diagnose motility disorders during initial upper endoscopy. If comparable to HREM, it could potentially improve patient care. Herein, we present our single center experience with EndoFLIP as a screening tool for esophageal dysmotility disorders and its comparability to HREM.

Methods: This was a single tertiary care center retrospective study. Patients ≥18yo who underwent HREM and EndoFLIP using the EF-322 catheter were included. The Chicago Classification v4.0 was used for diagnoses. Patients were excluded if they underwent EndoFLIP with the EF-325 catheter, had altered anatomy, had an incomplete study, or if HREM and EndoFLIP were longer than a year apart. The area under the curve (AUC) under 0.7 was used to estimate significance of results. Statistical significance was represented by p< 0.05.

Results: 46 patients were included. The median age was 54.9±14.7yo. 76% were females. Main symptoms were dysphagia (41%), GERD (28%) and cough (9%). The EGJ DI was lower in patients with abnormal manometry at all volumes, compared with those with normal HREM (Figure 1). The AUC for all DI values was above 0.7. The median CSA showed an estimated AUC moderate at 0.7 for 50 mL, and below 0.7 for 40mL. Differences in EGJ pressure showed a statistical significance at 40ml. The AUC was below 0.7 for all pressures. For the median diameter at 50mL and 60mL, AUC indicated moderate discriminatory ability for diameter with values above 0.7 at 50 and 60mL and below 0.7 at 40mL (Table 1). 70% of patients had antegrade repetitive contractions, with a higher percentage of individuals with normal manometry 86%, although not significant. No other contraction patterns showed significant differences.

Discussion: EGJ DI at all volumes, CSA, and diameter at 50 and 60mL had a moderate level of discriminatory power to detect the presence of abnormality using EndoFLIP. This technique is a potentially safe and valuable screening and complementing tool that could be used during initial endoscopy in patients with suspected esophageal motility disorders. More studies are needed to validate its use.




Disclosures:


Jose V. Camilion, BA¹, Ernesto Robalino Gonzaga, MD², Gala Godoy Brewer, MD³, Robert S. Bulat, MD⁴, Tsion Abdi, MD⁵, Olaya I. Brewer, MD⁶. P0433 - Endoscopic Functional Luminal Imaging Probe as a Screening Tool for Esophageal Disorders: A Single Center Experience, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.