High-resolution Manometry in Patients with Gastroesophageal Reflux Disease Before and After Fundoplication.
- Author:
Katarzyna RERYCH
1
;
Józef KUREK
;
Ewa KLIMACKA-NAWROT
;
Barbara BŁOŃSKA-FAJFROWSKA
;
Antoni STADNICKI
Author Information
- Publication Type:Original Article
- Keywords: Esophageal motility disorders; Fundoplication; Gastroesophageal reflux disease; Hiatal hernia; Manometry
- MeSH: Classification; Deglutition; Deglutition Disorders; Esophageal Motility Disorders; Esophagogastric Junction; Esophagus; Fundoplication*; Gastroesophageal Reflux*; Hernia, Hiatal; Humans; Manometry*; Peristalsis; Relaxation; Water
- From:Journal of Neurogastroenterology and Motility 2017;23(1):55-63
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The study aimed to determine pre- and post-fundoplication esophagogastric junction (EGJ) pressure and esophageal peristalsis by high-resolution manometry (HRM) in patients with gastroesophageal reflux disease (GERD). METHODS: Pre-operative and post-operative HRM data from 25 patients with GERD were analyzed using ManoView version 2.0.1. with updated software for Chicago classification and pressure topography. The study involved swallowing water boluses of 10 mL in the upright position. RESULTS: Significant increase of mean basal EGJ pressure and minimal basal EGJ pressure was found in post-operative as compared with preoperative patients (P < 0.05 and P < 0.001, respectively). Integrated relaxation pressure (IRP) reached higher values in post-operative patients than in pre-operative patients (P < 0.001). Intra-bolus pressure (IBP) was significantly higher (P < 0.05) and contractile front velocity (CFV) was slower (P < 0.01) in post-operative patients than in pre-operative patients. Moreover significant increase of distal contractile integral (DCI) was found in post-operative patients (P < 0.05). Hiatal hernia was detected by HRM in 11 pre-operative patients. Fifteen out of 25 post-operative patients complained of dysphagia. CONCLUSIONS: Fundoplication restores the antireflux barrier by reinforcing EGJ basal pressures, repairing hiatal hernias, and enhances peristaltic function of the esophagus by increasing DCI. However slight IRP elevation found in post-fundoplication patients may result in bolus pressurization and motility disorders.
