Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomes.

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
Vivian Grünherz, Alanna Ebigbo, Miriam Elia, Alessandra Brunner, Tamara Krafft, Leo Pöller, Pia Schneider, Fabian Stieler, Bernhard Bauer, Anna Muzalyova, Helmut Messmann, Sandra Nagl
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引用次数: 0

Abstract

Background and aims: Peroral endoscopic myotomy (POEM) is a standard treatment option for achalasia patients. Treatment response varies due to factors such as achalasia type, degree of dilatation, pressure and distensibility indices. We present an innovative approach for treatment response prediction based on an automatic three-dimensional (3-D) reconstruction of the tubular oesophagus (TE) and the lower oesophageal sphincter (LES) in patients undergoing POEM for achalasia.

Methods: A software was developed, integrating data from high-resolution manometry, timed barium oesophagogram and endoscopic images to automatically generate 3-D reconstructions of the TE and LES. Novel normative indices for TE (volume×pressure) and LES (volume/pressure) were automatically integrated, facilitating pre-POEM and post-POEM comparisons. Treatment response was evaluated by changes in volumetric and pressure indices for the TE and the LES before as well as 3 and 12 months after POEM. In addition, these values were compared with normal value indices of non-achalasia patients.

Results: 50 treatment-naive achalasia patients were enrolled prospectively. The mean TE index decreased significantly (p<0.0001) and the mean LES index increased significantly 3 months post-POEM (p<0.0001). In the 12-month follow-up, no further significant change of value indices between 3 and 12 months post-POEM was seen. 3 months post-POEM mean LES index approached the mean LES of the healthy control group (p=0.077).

Conclusion: 3-D reconstruction provides an interactive, dynamic visualisation of the oesophagus, serving as a comprehensive tool for evaluating treatment response. It may contribute to refining our approach to achalasia treatment and optimising treatment outcomes.

Trial registration number: 22-0149.

接受 POEM 治疗的贲门失弛缓症患者食道的自动三维重建:评估治疗效果的创新方法。
背景和目的:口周内镜下肌切开术(POEM)是贲门失弛缓症患者的标准治疗方案。治疗反应因贲门失弛缓症类型、扩张程度、压力和扩张指数等因素而异。我们提出了一种创新的治疗反应预测方法,该方法基于对接受贲门失弛缓症切除术(POEM)患者的管状食道(TE)和下食道括约肌(LES)进行自动三维(3-D)重建:方法:开发了一款软件,整合了高分辨率测压、定时食管钡餐造影和内窥镜图像的数据,自动生成TE和LES的三维重建。TE(容积×压力)和LES(容积/压力)的新标准指数被自动整合,便于对POEM前和POEM后进行比较。在 POEM 之前以及之后 3 个月和 12 个月,通过 TE 和 LES 的容积和压力指数的变化来评估治疗反应。此外,还将这些值与非弛缓症患者的正常值指数进行了比较:50名未经治疗的贲门失弛缓症患者接受了前瞻性治疗。结论:三维重建提供了食道的交互式动态可视化,是评估治疗反应的综合工具。它可能有助于完善我们的贲门失弛缓症治疗方法并优化治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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