[Esophageal manometry and pH-monitoring in surgical indications]

In the context of esophageal disease, the study of motility and reflux by means of manometry and pH-metry has proved rewarding in terms of prospects thanks to the physiopathologic information it is capable of providing and to the clinical applications which, in many cases, are of considerable importance. In the area of surgery, in our experience, indications for manometry include: the physiopathologic definition of a variety of diseases such as achalasia, diffuse esophageal spasm, hypertonic conditions responsible even for the formation of diverticula, esophageal reflux in the presence of a hypotonic L.E.S.. Further indications are intra- and post-operative, to verify the extension and the validity of the surgery. Surgical indications for pH-metry must include all those conditions in which esophageal reflux is not underscored by means of other investigative tools. However the omnipresence of a surgical indication in these cases is debatable. In any event this objective will be within reach only after an adequate refinement of investigative techniques and the optimal utilization of the findings obtained in the course of diagnostic exploration.