Gastroenterology report · 2025
Feasibility and efficacy of pH-integrated ultrathin endoscopy for ambulatory gastroesophageal reflux monitoring (with videos).
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Hu Xiaoyu, Zhang Yaoping, Hao Jinyong, Tang Bofu, Zhang Yifan, Huang Xiaojun
Аннотация
BACKGROUND: Current techniques for monitoring gastroesophageal reflux are limited to measuring physicochemical parameters. We presented a novel pH-integrated ultrathin endoscope (the EndoMonitor System) for simultaneous acquisition of reflux images and pH data. This preclinical study evaluated the performance of the latest version of the EndoMonitor System.
METHODS: The stability and hydrogen ion selectivity of the pH electrode in the EndoMonitor System were evaluated. Subsequently, six types of reflux events were simulated in an isolated organ (porcine esophagus-stomach). Complete duodenal ligation was used to create porcine gastroesophageal reflux models. The number of reflux episodes and acid exposure time were assessed and compared with the pH-impedance catheter results.
RESULTS: The detection rates for distal acid reflux, distal mixed reflux, and horizontal acid reflux events of the EndoMonitor System were significantly higher than those of the pH-impedance catheter (100% vs 18.6%, 100% vs 32.7%, and 100% vs 49.1%, respectively; all P < 0.001). Furthermore, the EndoMonitor System demonstrated superior detection performance in proximal acid and mixed reflux events compared with the pH-impedance catheter (100% vs 90.9% and 100% vs 88.1%, respectively; both P < 0.05). In vivo reflux monitoring demonstrated statistically higher detection rates of reflux events with the EndoMonitor System in two-thirds of the experimental groups (P < 0.05), with a more remarkable overall detection advantage (100% vs 82.0%; P < 0.001). The acid exposure time measurement results for these two devices were comparable (mean ± standard deviation: 2.62 ± 1.82 vs 2.52 ± 1.74 min; P = 0.161).
CONCLUSIONS: The EndoMonitor System improves the accuracy of identifying reflux events and simplifies the monitoring process. It was also highly operable. This study provided important preclinical experience for clinical trials.
METHODS: The stability and hydrogen ion selectivity of the pH electrode in the EndoMonitor System were evaluated. Subsequently, six types of reflux events were simulated in an isolated organ (porcine esophagus-stomach). Complete duodenal ligation was used to create porcine gastroesophageal reflux models. The number of reflux episodes and acid exposure time were assessed and compared with the pH-impedance catheter results.
RESULTS: The detection rates for distal acid reflux, distal mixed reflux, and horizontal acid reflux events of the EndoMonitor System were significantly higher than those of the pH-impedance catheter (100% vs 18.6%, 100% vs 32.7%, and 100% vs 49.1%, respectively; all P < 0.001). Furthermore, the EndoMonitor System demonstrated superior detection performance in proximal acid and mixed reflux events compared with the pH-impedance catheter (100% vs 90.9% and 100% vs 88.1%, respectively; both P < 0.05). In vivo reflux monitoring demonstrated statistically higher detection rates of reflux events with the EndoMonitor System in two-thirds of the experimental groups (P < 0.05), with a more remarkable overall detection advantage (100% vs 82.0%; P < 0.001). The acid exposure time measurement results for these two devices were comparable (mean ± standard deviation: 2.62 ± 1.82 vs 2.52 ± 1.74 min; P = 0.161).
CONCLUSIONS: The EndoMonitor System improves the accuracy of identifying reflux events and simplifies the monitoring process. It was also highly operable. This study provided important preclinical experience for clinical trials.