title: High-resolution Manometry in Patients with Gastroesophageal Reflux Disease Before and After Fundoplication.
abstract: OBJECTIVE
  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 pre-operative patients (P< 0.05 andP< 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.
authors.affiliation: Department of Basic Biomedical Sciences, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Rerych
authors.affiliation: Department of General, Endocrine and Oncologic Surgery, Multidisciplinary Hospital, Jaworzno, Poland.
authors.forename: Józef
authors.initials: J
authors.lastname: Kurek
authors.affiliation: Department of Basic Biomedical Sciences, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Klimacka-Nawrot
authors.affiliation: Department of Basic Biomedical Sciences, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Błońska-Fajfrowska
authors.affiliation: Department of Basic Biomedical Sciences, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland.|Section of Gastrointestinal Motility, Multidisciplinary Hospital, Jaworzno, Poland.
authors.forename: Antoni
authors.initials: A
authors.lastname: Stadnicki
keywords: Esophageal motility disorders; Fundoplication; Gastroesophageal reflux disease; Hiatal hernia; Manometry