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Surg Endosc. 2015 Dec;29(12):3565-9. doi: 10.1007/s00464-015-4109-x. Epub 2015 Feb 21.

Significant pressure differences between solid-state and water-perfused systems in lower esophageal sphincter measurement.

Author information

1
Center of Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. philipp.gehwolf@i-med.ac.at.
2
Department of Surgery, Mayo Clinic Jacksonville, Jacksonville, FL, USA.
3
Department of Gastroenterology, Mayo Clinic Jacksonville, Jacksonville, FL, USA.
4
Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria.
5
Center of Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. heinz.wykypiel@i-med.ac.at.
6
Center of Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

Abstract

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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.

KEYWORDS:

GERD; Gastroesophageal junction; Lower esophageal sphincter (LES); Manometry

PMID:
25701063
DOI:
10.1007/s00464-015-4109-x
[Indexed for MEDLINE]

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