Mean pressure obtained by modified rapid pull-through technique used to assess lower esophageal sphincter function

• Published in: Digestive diseases and sciences Vol. 47; no. 11; pp. 2549 - 2553
• Main Authors: Alonso, P, Estévez, E, Aba, C, González-Conde, B, Yáñez, J, Vázquez-Iglesias, J L
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01-11-2002
• Subjects: Adolescent; Adult; Aged; Esophageal Achalasia - physiopathology; Esophagogastric Junction - physiology; Female; Gastroesophageal Reflux - physiopathology; Humans; Male; Manometry - methods; Middle Aged; Observer Variation
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1023/A:1020576529685

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.