Marie-Anne Guillaumot1, Chloé Léandri2, Sarah Leblanc2, Romain Coriat2, Frédéric Prat2, Stanislas Chaussade2, Maximilien Barret2. 1. Gastroenterology Department, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75010, Paris, France. marie-anne.g@hotmail.fr. 2. Gastroenterology Department, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75010, Paris, France.
Abstract
BACKGROUND: A novel three-dimensional high-resolution esophageal manometry provides a dynamic 360° representation of the pressure at the esophagogastric junction. AIMS: To describe the three-dimensional high-resolution esophageal manometry patterns of achalasia. METHODS: We retrospectively included all consecutive patients who underwent three-dimensional high-resolution esophageal manometry before and after treatment (pneumatic dilatation or per-oral endoscopic myotomy) for achalasia between November 2016 and July 2017. The distribution of the pressures at the esophagogastric junction on three-dimensional high-resolution esophageal manometry was determined. RESULTS: Eighteen patients were included. Mean integrated relaxation pressure was 20.7 mmHg, and median (range) Eckardt score was 7 (4-10). Nine patients were treated by pneumatic dilatation and seven by myotomy. Nine patients underwent three-dimensional high-resolution esophageal manometry after treatment. Before treatment, the esophagogastric junction pressure distribution was best observed at end expiration and during the 4 s of the integrated relaxation pressure measurement. During the integrated relaxation pressure, the lower esophageal sphincter was asymmetric in 12 patients with a high-pressure zone between the left and the posterior side of the esophagogastric junction. After treatment, five patients had a residual high-pressure point on the left or the posterior side of the esophagogastric junction. CONCLUSIONS: Three-dimensional high-resolution esophageal manometry allows a simple assessment of the pressure topography at the EGJ. In patients with achalasia, we found the esophagogastric junction pressure to be asymmetric with a peak pressure on the greater curvature side. Three-dimensional high-resolution esophageal manometry has the potential to guide initial and redo treatments.
BACKGROUND: A novel three-dimensional high-resolution esophageal manometry provides a dynamic 360° representation of the pressure at the esophagogastric junction. AIMS: To describe the three-dimensional high-resolution esophageal manometry patterns of achalasia. METHODS: We retrospectively included all consecutive patients who underwent three-dimensional high-resolution esophageal manometry before and after treatment (pneumatic dilatation or per-oral endoscopic myotomy) for achalasia between November 2016 and July 2017. The distribution of the pressures at the esophagogastric junction on three-dimensional high-resolution esophageal manometry was determined. RESULTS: Eighteen patients were included. Mean integrated relaxation pressure was 20.7 mmHg, and median (range) Eckardt score was 7 (4-10). Nine patients were treated by pneumatic dilatation and seven by myotomy. Nine patients underwent three-dimensional high-resolution esophageal manometry after treatment. Before treatment, the esophagogastric junction pressure distribution was best observed at end expiration and during the 4 s of the integrated relaxation pressure measurement. During the integrated relaxation pressure, the lower esophageal sphincter was asymmetric in 12 patients with a high-pressure zone between the left and the posterior side of the esophagogastric junction. After treatment, five patients had a residual high-pressure point on the left or the posterior side of the esophagogastric junction. CONCLUSIONS: Three-dimensional high-resolution esophageal manometry allows a simple assessment of the pressure topography at the EGJ. In patients with achalasia, we found the esophagogastric junction pressure to be asymmetric with a peak pressure on the greater curvature side. Three-dimensional high-resolution esophageal manometry has the potential to guide initial and redo treatments.
Authors: H Inoue; H Minami; Y Kobayashi; Y Sato; M Kaga; M Suzuki; H Satodate; N Odaka; H Itoh; S Kudo Journal: Endoscopy Date: 2010-03-30 Impact factor: 10.093
Authors: Mouen A Khashab; Reem Z Sharaiha; Payal Saxena; Joanna K Law; Vikesh K Singh; Anne Marie Lennon; Eun Ji Shin; Marcia Irene Canto; Gerard Aguila; Patrick I Okolo; Stavros N Stavropoulos; Haruhiro Inoue; Pankaj J Pasricha; Anthony N Kalloo Journal: Gastrointest Endosc Date: 2013-01 Impact factor: 9.427