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Reference high-resolution manometry values after magnetic sphincter augmentation.

Stefano Siboni1, Davide Ferrari1, Carlo Galdino Riva1

  • 1Division of General and Foregut Surgery, Department of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Milan, Italy.

Neurogastroenterology and Motility
|March 27, 2021
PubMed
Summary
This summary is machine-generated.

This study establishes high-resolution manometry (HRM) reference values for patients after magnetic sphincter augmentation (MSA) for gastroesophageal reflux disease (GERD). Crural repair alongside MSA improves outcomes and lower esophageal sphincter (LES) function.

Keywords:
Chicago Classificationcrural repairhigh-resolution manometryintegrated relaxation pressureintrabolus pressuremagnetic sphincter augmentationnormative values

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Diagnostic Manometry

Background:

  • Magnetic sphincter augmentation (MSA) is an innovative antireflux procedure.
  • Postoperative dysphagia can occur, and reference high-resolution manometry (HRM) values after MSA are lacking.
  • Understanding manometric changes post-MSA is crucial for patient management.

Purpose of the Study:

  • To define reference high-resolution manometry (HRM) values in patients after magnetic sphincter augmentation (MSA).
  • To assess the impact of concurrent crura repair on HRM values and clinical outcomes.
  • To establish normative data for post-MSA HRM parameters.

Main Methods:

  • High-resolution manometry (HRM) was performed in dysphagia-free patients post-MSA.
  • Reference values were determined using the 5th and 95th percentiles based on the Chicago Classification.
  • Analysis included the contribution of concurrent crura repair to lower esophageal sphincter (LES) competency.

Main Results:

  • Reference upper limits for integrated relaxation pressure (IRP) and intrabolus pressure (IBP) were established at 20.2 mmHg and 30.3 mmHg, respectively.
  • These values were higher post-MSA compared to normative Chicago Classification v3.0 data.
  • Patients with concurrent crura repair showed significantly higher IRP and improved GERDQ-A and Reflux Symptom Index scores.

Conclusions:

  • This study provides essential HRM reference values for patients who have undergone successful MSA.
  • Crural repair is a significant factor in enhancing LES augmentation and clinical outcomes.
  • These findings aid in the interpretation of manometric studies following MSA.