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首页> 外文期刊>Surgical Endoscopy >Routine esophageal manometry is not useful in patients with normal videoesophagram
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Routine esophageal manometry is not useful in patients with normal videoesophagram

机译：常规食管测量法在常规VideoSophagram的患者中无用

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Background Videoesophagram (VEG) and esophageal manometry (EM) are components of the preoperative evaluation for foregut surgery. EM is able to identify motility disorders and diminished contractility that may alter surgical planning. However, there are no clearly defined criteria to guide this. Reliable manometry is not always easily obtained, and therefore its necessity in routine preoperative evaluation is unclear. We hypothesized that if a patient has normal videoesophagram, manometry does not reveal clinically significant esophageal dysfunction. Methods We reviewed patients who underwent protocolized videoesophagram and manometry at our institution. Measures of esophageal motility including the mean distal contractile integral (DCI), mean wave amplitude (MWA), and percent of peristaltic swallows (PPS) were analyzed. The Chicago Classification was used for diagnostic criteria of motility disorders. Normal VEG was defined as stasis of liquid barium on less than three of five swallows. Results There were 418 patients included. 231 patients (55%) had a normal VEG, and 187 patients (45%) had an abnormal VEG. In the normal VEG group, only 2/231 (0.9%) patients had both abnormal DCI and PPS, 1/231 (0.4%) patients had both abnormal DCI and MWA and no patients had both abnormal MWA and PPS. There were no patients with achalasia or absent contractility and 1 patient with ineffective esophageal motility (IEM) in the normal VEG group. This was significantly different from the abnormal VEG group which included 4 patients with achalasia, 1 with absent contractility and 22 with IEM (p < 0.0001). The negative predictive value of VEG was 99.6% and the sensitivity was 96.4%. Conclusions A normal videoesophagram reliably excluded the presence of clinically significant esophageal dysmotility that would alter surgical planning. Routine manometry is not warranted in patients with normal videoesophagram, and should be reserved for patients with abnormal VEG.
机译：背景技术VideoSophagram（Veg）和食道测量（EM）是前鲁术后术前评估的组成部分。 EM能够识别可能改变手术规划的运动障碍和减少的收缩性。但是，没有明确定义的标准来指导这一点。并不总是容易获得可靠的测压，因此其在常规术前评估中的必要性尚不清楚。我们假设如果患者具有正常的VideoSophagram，则测压不会露出临床显着的食管功能障碍。方法介绍了在我们机构接受综合型荧光血药中的患者。分析了在内的食管运动措施，包括平均远端收缩积分（DCI），平均波振幅（MWA）和百分比吞咽百分比（PPS）。芝加哥分类用于动力障碍的诊断标准。普通蔬菜被定义为液体钡的静止，在5个燕子中不到3个。结果包括418名患者。 231例患者（55％）有普通蔬菜，187名患者（45％）蔬菜异常。在普通的veg组中，只有2/231（0.9％）患者的异常DCI和PPS，1/231（0.4％）患者患者异常和MWA，患者没有异常的MWA和PPS。在普通veg组中没有患有贲门刺症或缺乏收缩性的患者，1例食管运动（IEM）无效。这与异常veg组有显着差异，其中包含4例患者，1例患者1患者，具有缺乏收缩性，22例IEM（P <0.0001）。蔬菜的负面预测值为99.6％，敏感性为96.4％。结论正常的videoheophagram可靠地排除存在临床上显着的食管功能性，这将改变手术计划。常规VideoSophagram的患者不需要常规测压，并且应为veg异常的患者保留。

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