[Reliability of perfusion manometry in the gastro-esophageal closure mechanism (author's transl)]

Manometric investigation of the gastro-esophageal closure mechanism is an important tool for the classification and adequate therapy of functional disorders in this region. Because of the relatively low pressure differences the reliability of a measuring procedure has to meet all requirements. Manometry by continuously perfused and withdrawn catheters being the most frequently applied measuring procedure got some criticism regarding its reliability and reproducibility. The theoretical basis of this criticism is examined closely. The reproducibility of the recorded pressure curves is studied and quantified in 36 dogs and 122 persons (32 controls, 63 patients with hiatal hernia, 27 patients with achalasia of the cardia). On experimental condition, lower esophagel sphincter pressure shows a high degree of reproducibility (retest reliability r = .98, p less than 0.001), in clinical investigations it is significantly lower (r = .81). There are no statistically significant differences between the patient groups and the controls. The importance of the findings for the reliability and the interpretation of clinical manometric data is discussed.