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- Title
Significant pressure differences between solid-state and water-perfused systems in lower esophageal sphincter measurement.
- Authors
Gehwolf, Philipp; Hinder, Ronald; DeVault, Kenneth; Edlinger, Michael; Wykypiel, Heinz; Klingler, Paul; Hinder, Ronald A; DeVault, Kenneth R; Wykypiel, Heinz F; Klingler, Paul J
- Abstract
<bold>Objective: </bold>High-resolution manometry of the esophagus has gained worldwide acceptance, using different solid-state catheters. Thus, normal values for lower esophageal sphincter (LES) resting pressure in suspected gastroesophageal reflux disease patients have been established using water-perfused manometry. These standard values are commonly applied using also solid-state techniques, although they have never been compared before. The aim of the study was to compare LES measurements obtained with water-perfused manometry with a solid-state technique.<bold>Methods: </bold>Thirty healthy subjects were studied twice on the same day: Technique 1: Station pull through using a water-perfused catheter with ports arranged at 0°, 90°, 180° and 270° which were averaged to give a mean LES pressure. Technique 2: Solid-state circumferential probe with a single station pull through. Data were collected using the same computer system and program. The LES pressures were randomly and blindly analyzed.<bold>Results: </bold>Twenty-seven subjects out of 30 were analyzed. Using the solid-state system, the mean LES pressure was higher (15.0 vs. 23.3 mmHg, p = 0.003) and 19 of 27 (70%) individual measurements were higher. Two subjects had a hypertensive LES by solid state (58.6 resp. 47.5 mmHg), while their pressures were normal with water-perfused manometry (21.0 resp. 23.4 mmHg). The distal esophageal pressures (mean of pressure at 3 and 8 cm above LES) were the same with the two techniques.<bold>Conclusion: </bold>In normal control subjects, LES measurement using circumferential solid-state transducers yields higher pressures than standard water-perfused manometry. Which system yields the "true" resting pressure of the physiologic LES remains to be determined.
- Subjects
ESOPHAGOGASTRIC junction; ESOPHAGEAL surgery; GASTROESOPHAGEAL reflux treatment; GASTROESOPHAGEAL reflux; QUESTIONNAIRES; CHEST pain; DEGLUTITION disorders; SURGERY; DISEASES; ESOPHAGEAL physiology; GASTROESOPHAGEAL reflux diagnosis; ESOPHAGEAL motility disorders; MANOMETERS; REFERENCE values; WATER; EQUIPMENT &; supplies
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2015, Vol 29, Issue 12, p3565
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-015-4109-x