Document Detail


The value of high-resolution manometry in the assessment of the resting characteristics of the lower esophageal sphincter.
MedLine Citation:
PMID:  19779945     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: High-resolution manometry (HRM) is faster and easier to perform than conventional water perfused manometry. There is general acceptance of its usefulness in evaluating upper esophageal sphincter and esophageal body. There has been less emphasis on the use of HRM to evaluate the lower esophageal sphincter (LES) resting pressure and length, both factors important in LES barrier function. The aim of this study was to compare the resting characteristics of the LES determined by HRM and conventional manometry in the same patients. METHODS: We performed both HRM and conventional manometry including a slow motorized pull-through technique in 55 patients with foregut symptoms. The characteristics of the LES analyzed were: resting pressure, total length, and abdominal length. Four available modes of HRM analysis were used to assess resting characteristics of the LES: spatiotemporal mode using both abrupt color change and isobaric contour, line tracing, and pressure profile. The values obtained from these four HRM modes were then compared to the conventional manometry measurements. RESULTS: High-resolution manometry and conventional manometry did not differ in their measurement of LES resting pressure. LES overall and abdominal length were consistently overestimated by HRM. A variability up to 4 cm in overall length was observed and was greatest in patients with hiatal hernia (1.8 vs. 0.9 cm, p = 0.027). CONCLUSION: The current construction of the catheter and software analysis used in high-resolution manometry do not allow precise measurement of LES length. Errors in the identification of the upper border of the sphincter may compromise accurate positioning of a pH probe.
Authors:
Shahin Ayazi; Jeffrey A Hagen; Joerg Zehetner; Oliver Ross; Calvin Wu; Arzu Oezcelik; Emmanuele Abate; Helen J Sohn; Farzaneh Banki; John C Lipham; Steven R DeMeester; Tom R Demeester
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-09-25
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  13     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-04-02     Revised Date:  2010-08-25    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2113-20     Citation Subset:  IM    
Affiliation:
Division of Thoracic and Foregut Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, Suite 514, Los Angeles, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Esophageal Sphincter, Lower / physiology*
Female
Gastroesophageal Reflux / physiopathology*
Hernia, Hiatal / physiopathology
Humans
Male
Manometry / methods*
Middle Aged
Comments/Corrections
Comment In:
J Gastrointest Surg. 2010 Sep;14(9):1466-7; author reply 1468-9   [PMID:  20593307 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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