title: Mean pressure obtained by modified rapid pull-through technique used to assess lower esophageal sphincter function.
abstract: Lower esophageal sphincter pressure, length of sphincter, and contraction of the crural diaphragm are determinants of esophageal function. Mean pressure manometrics in modified rapid pull-through reflects these three factors. Reproducibility and interobserver variability were studied to assess this method's efficacy and were compared with the maximum expiratory pressure in station pull-through in 44 individuals divided into three groups: achalasia, gastroesophageal reflux, and healthy volunteers. Mean pressure in rapid pull-through showed high reproducibility, no significant differences (14.4 +/- 8.4 vs 12.6 +/- 8.2 mm Hg) between two measurements, and a high correlation coefficient (r = 0.9). Interobserver variability was lower than that seen for maximum expiratory pressure (P < 0.001). Mean pressure was lower than maximum expiratory pressure in patients with achalasia (21.1 +/- 7 vs 30.7 +/- 8.6 mm Hg). Both methods showed identical sensitivity to establish a hypotensive sphincter in patients with reflux (73%). We think that mean pressure obtained by rapid pull-through is a good methodology to assess lower esophageal sphincter competence. It is rapid, simple, shows good reproducibility and low interobserver variability, and is clinically valid.
authors.affiliation: Department of Digestive Diseases, Hospital Juan Canalejo, La Corufia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Alonso
authors.forename: E
authors.initials: E
authors.lastname: Estévez
authors.forename: C
authors.initials: C
authors.lastname: Aba
authors.forename: B
authors.initials: B
authors.lastname: González-Conde
authors.forename: J
authors.initials: J
authors.lastname: Yáñez
authors.forename: J L
authors.initials: JL
authors.lastname: Vázquez-Iglesias
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004931:Esophageal Achalasia / Q000503:physiopathology*; D004943:Esophagogastric Junction / Q000502:physiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation