High-resolution manometry in achalasia of esophagus
Keywords:
High resolution manometry, achalasia of esophagus, Chicago classification.Abstract
Introduction: High-resolution esophageal manometry is the ideal test for the diagnosis of achalasia and shows the presence of tertiary waves or aperistalsis and increased pressure, in the absence of relaxation, of the lower esophageal sphincter.Objective: To assess the usefulness of high-resolution esophageal manometry in the diagnosis and classification of esophageal achalasia.
Methods: A descriptive, cross-sectional investigation was carried out at the National Center for Minimal Access Surgery, between October 2018 and December 2019, in 46 patients with a diagnosis of esophageal achalasia. Those with previous esophageal surgery were excluded. The variables included were: age, sex, time of evolution, symptoms and manometric findings. For the analysis of the results, the percentage and measures of central tendency (arithmetic mean and standard deviation) were used.
Results: Type II achalasia predominated in females (57 %). Dysphagia was the most frequent symptom (84, 76, and 100 % in types I, II, and III, respectively). 70 % of the cases presented more than one year of evolution of the symptoms. Regarding the high-resolution manometry parameters, it was observed that regardless of the type, the mean integrated relaxation pressure was above 21 mmHg. No patients with type III achalasia subtypes were found.
Conclusions: High-resolution esophageal manometry is useful for the diagnosis and classification of esophageal acalasia.
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References
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22. Duffiel JA, Hamer PW, Heddle R, Holloway R, Myers JC, Thompson SK. Incidence of Achalasia in south Australia based on esophageal manometry findings. Clinical Gastroenterology Hepatology. 2017 [acceso: 12/05/2020]; 15(3):360-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27266979/
23. Park S, Zifan A, Kumar D, Mittal RK. Genesis of Esophageal Pressurization and Bolus Flow Patterns in Patients With Achalasia Esophagus. Gastroenterology. 2018 [acceso: 23/05/2021]; 155(2):327-336. DOI: 10.1053/j.gastro.2018.04.033
2. Van Hoeij FB, Bredenoord AJ. Clinical application of esophageal high resolution manometry in the diagnosis of esophageal motility disorders. J Neurogastroenterol Motl. 2016[acceso: 16/03/2020]; 22(1):6-13. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26631942/
3. Bredenoord AJ, Smout AJ. High-resolution manometry. Digestive and Liver Disease. 2008 [acceso: 16/03/2020]; 40 (3):174-181. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1590865807006263
4. Schlotmann Patti MG. Primary esophageal motility disorders: Beyond Achalasia. Int J Mol Sci. 2017[acceso: 16/03/2020]; 18(7):1399. Disponible en: https://doi.org/10.3390/ijms18071399
5. Samo S, Carlson DA , Gregory DL , Gawel SH , Pandolfino JR , Kahrilas PJ. Incidence and Prevalence of Achalasia in Central Chicago, 2004-2014, Since the Widespread use of High-Resolution Manometry. Clin Gastroenterol Hepatol. 2017[acceso: 16/03/2020]; 15(3):366-73. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27581064/
6. Fox MR, Bredenoord AJ. Esophageal high-resolution manometry: moving from research into clinical practice. Gut 2008 [acceso: 16/03/2020]; 57(3):405-23. Disponible en: https://gut.bmj.com/content/57/3/405
7. Salvador R, Dubz A, Polomsky M, Gellerson O, Jones CE, Raymond DP, et al. A new era in esophageal diagnostics: the image-based paradigm of high-resolution manometry. J Am CollSurg 2009[acceso: 16/03/2020]; 208(6):1035-44. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19476889/
8. Pandolfino JE, Ghosh SK, Rice J, Clarke JO, Wiatek MA, Kahrilas PJ. Classifying esophageal motility by pressure topography characteristics: a study of 400 patients and 75 controls. Am J Gastroenterol 2008 [acceso: 16/03/2020]; 103(1):27-37. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17900331/
9. Pandolfino JE, Kim H, Ghosh SK, Clarke JO, Zhang Q, Kahrilas PJ. High-resolution manometry of the EGJ: ananalysis of crural diaphragm function in GERD. Am J Gastroenterol. 2007[acceso: 16/03/2020]; 102(5):1056-63. Disponible en: https://doi.org/10.1111/j.1572-0241.2007.01138.x
10. Pandolfino JE, Kwiatek MA, Nealis T, Bulsiewicz W, Post J, Kahrilas PJ. Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology 2008[acceso: 16/03/2020]; 135(5):1526-33. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18722376/
11. Pandolfino JE, Kwiatek MA, Ho K,Scherer JR, Kahrilas PJ. Unique features of esophagogastric junction pressure topography in hiatus hernia patients with dysphagia. Surgery 2010 [acceso: 16/03/2020]; 147(1):57-64. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19744454/
12. Arora Z, Thota PN, Sanaka MR. Achalasia: current therapeutic options. Ther Adv Chronic Dis. 2017 [acceso: 16/03/2020]; 8(67):101-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28717439/
13. Anido Escobar V, Amable Díaz T, Labrada Sosa. M, Armenteros Torre MC, Diaz Drake Z. La manometría de alta resolución en los trastornos motores del esófago. Introducción en Cuba. Rev Haban Cienc Méd. 2020 [acceso: 12/04/2021]; 19(4):[aprox. 3 p.]. Disponible en: https://www.revhabanera.sld.cu/index.php/rhab/article/view/3150
14. Mayberry JF. Epidemiology and demographics of achalasia. Gastrointest Endosc Clin N Am 2001[acceso: 16/03/2020]; 11(2):235-47. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11319059/
15. Sopeña BF. Acalasia y manometría esofágica de alta resolución: experiencia del hospital clínico universitario Lozano Blesa. Saragoza: Universidad de Saragoza; 2015[acceso: 16/03/2020]. Disponible en: https://zaguan.unizar.es/record/47802/files/TAZ-TFG-2015-1101.pdf
16. Ramirez M, Patti MG. Changes in the diagnosis and treatment of achalasia. Clinical And Translational Gastroenterology. 2015 [acceso: 16/03/2020]; 6(5):e87. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452633 .
17. Meillier A, Midani D, Caroline D, Saadi M, Parkman H, Schey R. Difference of achalasia subtypes based on clinical symptoms, radiographic findings, and stasis scores. Revista de Gaastroenterología de México. 2018 [acceso: 23/05/2021]; 83(1):3-8. Disponible en: https://doi.org/10.1016/j.rgmx.2017.03.008
18. Garrigues Gil V, Ortiz Bellver V. Trastornos motores esofágicos. Gastroenterología Hepatología Continuada. 2010[acceso: 16/03/2020]; 9(6):275-80. Disponible en: https://aeeh.es/wp-content/uploads/2012/04/v9n6a640pdf001.pdf
19. Triggs JR, Carlson DA, Beveridge C, Jain A, Tye MY, Kahrilas PJ, et al. Upright integrated relaxation pressure facilitates characterization of esophagogastric junction out flow obstruction. Clin Gastroenterology and Hepat. 2019 [acceso: 12/05/2020]; 7(11):2218-26. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(19)30071-0
20. Anido Escobar V, Amable Díaz T, Labrada Sosa. M, Armenteros Torre MC, Diaz Drake Z. La manometría de alta resolución en los trastornos motores del esófago. Introducción en Cuba. Rev Haban Cien Méd. 2020 [acceso: 12/04/2021]; 19(4):[aprox. -3 p.]. Disponible en: https://www.revhabanera.sld.cu/index.php/rhab/article/view/3150
21. Sanagapalli S, Roman S, Hastier A, Leong RW, Patel K, Raeburn A, et al. Achalasia diagnosed despite normal integrated relaxation pressure responds favorably to therapy. Neurogastroenterol Motility. 2019 [acceso: 12/05/2020]; 31(5): [Aprox. 2 p.]. Disponible en: https://doi.org/10.1111/nmo.13586
22. Duffiel JA, Hamer PW, Heddle R, Holloway R, Myers JC, Thompson SK. Incidence of Achalasia in south Australia based on esophageal manometry findings. Clinical Gastroenterology Hepatology. 2017 [acceso: 12/05/2020]; 15(3):360-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27266979/
23. Park S, Zifan A, Kumar D, Mittal RK. Genesis of Esophageal Pressurization and Bolus Flow Patterns in Patients With Achalasia Esophagus. Gastroenterology. 2018 [acceso: 23/05/2021]; 155(2):327-336. DOI: 10.1053/j.gastro.2018.04.033
Published
2021-07-01
How to Cite
1.
Amable Días T, Anido Escobar VM, Martínez Leyva L, Armenteros Torres MC, Días Drake Z, Brizuela Quintanilla RA, et al. High-resolution manometry in achalasia of esophagus. Rev Cubana Med Milit [Internet]. 2021 Jul. 1 [cited 2024 Dec. 29];50(3):e02101289. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/1289
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