[Intraoperative esophageal manometry]

The intraoperative esophageal manometry (IEM) has been used to improve results in operative management of gastroesophageal reflux and achalasia. The IEM pointed out the necessity to perform an antireflux procedure with an intraoperative sphincter pressure higher than normal, because the measured postoperative sphincter pressures were one-half the intraoperative values measured after repair. Nevertheless some authors failed to find any correlation between intraoperative and subsequent postoperative sphincter pressure measurements. The Authors, in their experience, achieved the same results with and without IEM in the surgical management of gastroesophageal reflux and achalasia. For this reason The IEM does not seem to be necessary when performing the standard Nissen or Heller procedure. It is probably useful in the surgical treatment of patients with motor disorders or sclerodermia associated with reflux and in patients who have had multiple prior operations for reflux or achalasia.