High-resolution esophageal manometry in clinical practice – An Indian perspective

2021 ◽  
Vol 1 (2) ◽  
pp. 75
Author(s):  
Mayank Jain
2018 ◽  
Vol 95 (12) ◽  
pp. 1127-1136 ◽  
Author(s):  
I. V. Maev ◽  
E. V. Barkalova ◽  
M. A. Hovsepyan ◽  
Yu. A. Kucheryavy ◽  
Dmitry N. Andreyev

At present, esophageal manometry high-resolution (high resolution manometry, HRM) is a highly informative and promising method for diagnosing patients with different disorders of the motor function of the thoracic esophagus and disorders of tone of the sphincter apparatus. This article presents a series of observations that demonstrate the diagnostic capabilities of the methodology in current clinical practice.


2018 ◽  
Vol 158 (10) ◽  
pp. 4-9
Author(s):  
S.R. Abdulhakov ◽  
◽  
S.F. Bagnenko ◽  
D.S. Bordin ◽  
A.J. Bredenoord ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazumasa Muta ◽  
Eikichi Ihara ◽  
Shohei Hamada ◽  
Hiroko Ikeda ◽  
Masafumi Wada ◽  
...  

AbstractThe preparatory accommodation response of lower esophageal sphincter (LES) before swallowing is one of the mechanisms involved in LES relaxation during wet swallows, however, the physiological and/or pathological roles of LES accommodation remain to be determined in humans. To address this problem, we conducted a prospective observational study of 38 patients with normal high-resolution manometry (HRM) and 23 patients with idiopathic esophagogastric junction outflow obstruction (EGJOO) to assess dry and wet swallows. The LES accommodation measurement was proposed for practical use in evaluating the LES accommodation response. Although swallow-induced LES relaxation was observed in both dry and wet swallows, LES accommodation (6.4, 3.1–11.1 mmHg) was only observed in wet swallows. The extent of LES accommodation was impaired in idiopathic EGJOO (0.6, − 0.6–6 mmHg), and the LES accommodation measurement of patients with idiopathic EGJOO (36.8, 29.5–44.3 mmHg) was significantly higher in comparison to those with normal HRM (23.8, 18–28.6 mmHg). Successful LES relaxation in wet swallowing can be achieved by LES accommodation in combination with swallow-induced LES relaxation. Impaired LES accommodation is characteristic of idiopathic EGJOO. In addition to the IRP value, the LES accommodation measurement may be useful for evaluating the LES relaxation function in clinical practice.


2020 ◽  
pp. neurintsurg-2020-017053
Author(s):  
Emanuele Orru' ◽  
Miklos Marosfoi ◽  
Neil V Patel ◽  
Alexander L Coon ◽  
Christoph Wald ◽  
...  

BackgroundExisting travel restrictions limit the mobility of proctors, significantly delaying clinical trials and the introduction of new neurointerventional devices. We aim to describe in detail technical and legal considerations regarding international teleproctoring, a tool that could waive the need for in-person supervision during procedures.MethodsInternational teleproctoring was chosen to provide remote supervision during the first three intracranial aneurysm treatments with a new flow diverter (currently subject of a clinical trial) in the US. Real-time, high-resolution transmission software streamed audiovisual data to a proctor located in Canada. The software allowed the transmission of images in a de-identified, HIPAA-compliant manner.ResultsAll three flow diverters were implanted as desired by operator and proctor and without complication. The proctor could swap between images from multiple sources and reported complete spatial and situational awareness, without any significant lag or delay in communication. Procedural times and radiologic dose were similar to those of uncomplicated, routine flow diversion cases at our institution.ConclusionsInternational teleproctoring was successfully implemented in our clinical practice. Its first use provided important insights for establishing this tool in our field. With no clear horizon for lifting the current travel restrictions, teleproctoring has the potential to remove the need for proctor presence in the angiography suite, thereby allowing the field to advance through the continuation of trials and the introduction of new devices in clinical practice. In order for this tool to be used safely and effectively, highly reliable connection and high-resolution equipment is necessary, and multiple legal nuances have to be considered.


Author(s):  
Catiele Antunes ◽  
Elinor Zhou ◽  
Jad Abimansour ◽  
Daniella Assis ◽  
Olaya I. Brewer Gutierrez ◽  
...  

High-resolution esophageal manometry (HRM) is frequently used in the outpatient setting, but its role in the inpatient setting is unknown. We conducted a retrospective study of patients who underwent inpatient or outpatient HRM. Few differences were noted between groups and 28% of inpatients had an additional intervention. Tolerance of oral diet and diabetes were associated with a lower likelihood of additional intervention. Ultimately, the inpatient HRM group had unique characteristics and few subsequent interventions.


Author(s):  
Rena Yadlapati ◽  
Peter J. Kahrilas

Chicago Classification version 4.0 (CC v4.0), published in 2021, presents several modifications largely aimed at minimizing over-diagnosis of inconclusive patterns on high-resolution manometry (HRM). These include: (1) introduction of a standardized HRM protocol for consistency among centers, (2) emphasis on the need for supportive data in instances of inconclusive manometric patterns, (3) required presence of relevant symptoms in certain instances to reduce over-diagnosis and inappropriate interventions, and (4) classification as disorders of EGJ outflow or disorders of peristalsis. These updates aim to improve the clinical application of HRM and patient outcomes.


2008 ◽  
Vol 22 (4) ◽  
pp. 365-368 ◽  
Author(s):  
Daniel C Sadowski ◽  
Linda Broenink

INTRODUCTION: High-resolution manometry (HRM) of the esophagus is a new technique that provides a more precise assessment of esophageal motility than conventional techniques. Because HRM measures pressure events along the entire length of the esophagus simultaneously, clinical procedure time should be shorter because less catheter manipulation is required. According to manufacturer advertising, the new HRM system is more accurate and up to 50% faster than conventional methods.OBJECTIVE: To test the hypothesis that clinical testing with HRM requires less procedural time than a standard water perfusion (WP) method.METHODS: Forty-one consecutive patients were studied (20 underwent WP and 21 underwent HRM). Using time-motion analysis, the start and end times for each task associated with performing the study were recorded. Patient discomfort and study quality were also assessed by using five- and four-point qualitative scales, respectively.RESULTS: Total procedure time was reduced on average by 25.6% in the HRM group (from 41.8 minutes with WP to 30.7 minutes with HRM, P<0.05). There was no significant difference in the discomfort scores reported by the study subjects and no difference in study quality.CONCLUSIONS: HRM requires less time to complete than conventional manometry and should therefore shorten the wait-times of patients scheduled for esophageal manometry and have a significant impact on the cost of performing this commonly used clinical investigation.


2011 ◽  
Vol 140 (5) ◽  
pp. S-300
Author(s):  
Lubomyr Boris ◽  
Kiran Bidari ◽  
Sabine Roman ◽  
Daniel Luger ◽  
Monika A. Kwiatek ◽  
...  

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