Adult esophagogastric junction distensibility during general anesthesia assessed with an endoscopic functional luminal imaging probe (EndoFLIP^®)

Abstract

Background

Increased esophagogastric junction distensibility occurs with esophageal reflux. The EndoFLIP^® is now available as a clinical tool to measure this. Control data for patients without reflux has to date only been available for a handful of patients evaluated under sedation during endoscopy. This study explores the baseline data for patients who undergo laparoscopy using general anesthesia with pneumoperitoneum.

Methods

Patients who require surgery in the absence of a history of esophageal reflux underwent EndoFLIP^® evaluation of pressure, cross-sectional area, and distensibility with bag fills of 30 and 40 ml. This was performed after induction of anesthesia, during pneumoperitoneum, and just before extubation.

Results

Baseline levels were established and were noted to be significantly affected by the impact of pneumoperitoneum, with negligible effects from general anesthesia, patient gender, age, body mass index, or muscle relaxation.

Conclusions

These data provide a guide for more accurate intraoperative EndoFLIP^® calibration of crural hiatal repair during surgery.