416. FEASIBILITY STUDY ON THE INTRA-OPERATIVE USE OF IMPEDANCE PLANIMETRY (ENDOFLIP) TO ASSESS PYLORIC FUNCTION DURING ESOPHAGECTOMY
Bibliographic record
Abstract
Abstract Background Esophagectomy remains the cornerstone of curative treatment of esophageal cancer. Despite this, the optimal management of the pylorus remains unclear. In open surgery, a pyloroplasty, pyloromyotomy or finger fracture of the pylorus has been standard. In minimally invasive surgery, pyloric procedures are frequently excluded. Approximately 16% of patients will subsequently require endoscopic dilation of their pylorus due to issues with conduit function. Conversely, those with a pyloric procedure have significantly higher rates of dumping. The aim of this feasibility study is to determine whether intra-operative impedance planimetry (EndoFLIP) assessment of the pylorus may help identify those who will benefit from an up-front pyloric procedure. Methods 20 consecutive patients undergoing esophagectomy for esophageal cancer were consented and enrolled. At the conclusion of the operative procedure, when assessing the anastomosis and conduit endoscopically, the EndoFLIP catheter was passed with the endoscope. Diameter of the pyloric lumen and distensibility index (DI) were recorded for a range of balloon pressures. Results There were significant variations in lumen diameter and DI between patients. Mean lumen diameter with 30 mL balloon volume is 8.3 mm (5.1–11.3), with 40 mL balloon volume is 12.5 mm (11.6–13.8), and with 50 mL balloon volume is 14.9 mm (13.9–15.9). Mean DI at 30 mL is 5.77 (1.35–13.5), at 40 mL is 8.64 (4.59–17.0) and at 50 mL is 12.7 (3.56–38.0). Conclusion EndoFLIP assessment of pyloric function is feasible during esophagectomy. There are significant variations in pyloric measurements between patients. This may allow personalised management of the pylorus for patients undergoing minimally invasive esophagectomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".