Abstract
Water-perfused high resolution manometry system. High-resolution manometry is more costly but clinically superior to conventional manometry. Water-perfused systems may decrease costs, but it is unclear if they are as reliable as solid-state systems, and reference values are interchangeable. To validate normal values for a new water-perfusion high-resolution manometry system. Normative values for a 24-sensors water perfused high-resolution manometry system were validated by studying 225 individuals who underwent high resolution manometry for clinical complaints. Patients were divided in four groups: group 1 - gastroesophageal reflux disease; group 2 - achalasia; group 3 - systemic diseases with possible esophageal manifestation; and group 4 - dysphagia. In group 1, a hypotonic lower esophageal sphincter was found in 49% of individuals with positive 24 h pH monitoring, and in 28% in pH-negative individuals. In groups 2 and 3, aperistalsis was found in all individuals. In group 4, only one patient (14%) had normal high-resolution manometry. The normal values determined for this low-cost water-perfused HRM system with unique peristaltic pump and helicoidal sensor distribution are discriminatory of most abnormalities of esophageal motility seen in clinical practice.
Highlights
High-resolution manometry (HRM) is more intuitive, comfortable and clinically superior as compared to conventional manometry; it is very costly . 4,20 HRM originated from a water-perfused system[7] and current parameters were defined based on solid-state systems[14]
In patients with GERD, confirmed by pH monitoring test, 51 patients (49%) had a hypotonic lower esophageal sphincter (LES) and 21 (20%) had ineffective esophageal motility (IEM)
Most authors realized that manometry systems are different and normative values must be defined for each type of equipment
Summary
High-resolution manometry (HRM) is more intuitive, comfortable and clinically superior as compared to conventional manometry; it is very costly . 4,20 HRM originated from a water-perfused system[7] and current parameters were defined based on solid-state systems[14]. 4,20 HRM originated from a water-perfused system[7] and current parameters were defined based on solid-state systems[14]. Water-perfused systems may decrease costs using cheaper catheters with longer lifespan, but it has limitations on the total number of sensors, jeopardizing the maximum advantage of HRM, namely the high-density of close-spaced sensors. It is unclear if water-perfused systems are as reliable as solid-state systems and reference values may be imported from solid-state systems. Reusable polyvinyl chloride (PVC) catheter had channels in different configuration for the analysis of the pharynx, the esophageal body and the lower esophageal sphincter (LES). Water-perfusion was provided by an original patented controlled peristaltic pump (Figures 1 and 2)
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