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THE CHALLENGE OF DIAGNOSTIC ASSESSMENT OF A FAILED FUNDOPLICATION: BENEFITS OF HIGH RESOLUTION MANOMETRY OF THE GE-JUNCTION Attila Dubecz MD ; Renato Salvador MD; Marek Polomsky MD; Thomas J. Watson MD; Carolyn Jones MD; Jeffrey H. Peters MD  Department of Surgery, University of Rochester, School of Medicine and Dentistry, Rochester, NY Background Study   Aim Conclusions Functional information allowing insight into the cause of recurrent symptoms in symptomatic patients following failed fundoplication can be key to clinical decision making.  Evaluate manometric signs of outflow obstruction in patients with post-fundoplication dysphagia. HRM revealed high residual pressures, low percent LES relaxations and high intrabolus pressure of the neo-high pressure zone in virtually all patients with post-fundoplication dysphagia.  The image based analysis and high density of recording sides coupled with software interpolation available in HRM, allows novel and clinically useful observations in the evaluation of complex esophageal pathology. Patients and Methods  Results Patients:  28 patients (5 male / 23 female)  Symptoms : 17 dysphagia, 8 chestpain, 5 heartburn,  5 regurgitation, 2 cough, 2 vomiting  Manometric Data-acquisition and Analysis : ManoScan & ManoView TM  (Sierra Scientific Instruments) Intrabolus pressures: MATLAB TM Impaired Relaxation We compared the manometric results of post-fundoplication patients with and without dysphagia with 50 healthy controls. High Intrabolus Pressure <57% Percent LES Relaxation >15 mmHg LES Residual Pressure >20mmHg Intrabolus Pressure Manometric signs of outflow obstruction 27 11 3 No Dysphagia p<0.001 94 17 16 Dysphagia 油 % Total # of Patients with Manometric Evidence of Outflow Obstruction (any of 3) 油 Two Distal High Pressure Zones (LES and Diaphragmatic Crura)
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My DDW 2008 Poster

  • 1. THE CHALLENGE OF DIAGNOSTIC ASSESSMENT OF A FAILED FUNDOPLICATION: BENEFITS OF HIGH RESOLUTION MANOMETRY OF THE GE-JUNCTION Attila Dubecz MD ; Renato Salvador MD; Marek Polomsky MD; Thomas J. Watson MD; Carolyn Jones MD; Jeffrey H. Peters MD Department of Surgery, University of Rochester, School of Medicine and Dentistry, Rochester, NY Background Study Aim Conclusions Functional information allowing insight into the cause of recurrent symptoms in symptomatic patients following failed fundoplication can be key to clinical decision making. Evaluate manometric signs of outflow obstruction in patients with post-fundoplication dysphagia. HRM revealed high residual pressures, low percent LES relaxations and high intrabolus pressure of the neo-high pressure zone in virtually all patients with post-fundoplication dysphagia. The image based analysis and high density of recording sides coupled with software interpolation available in HRM, allows novel and clinically useful observations in the evaluation of complex esophageal pathology. Patients and Methods Results Patients: 28 patients (5 male / 23 female) Symptoms : 17 dysphagia, 8 chestpain, 5 heartburn, 5 regurgitation, 2 cough, 2 vomiting Manometric Data-acquisition and Analysis : ManoScan & ManoView TM (Sierra Scientific Instruments) Intrabolus pressures: MATLAB TM Impaired Relaxation We compared the manometric results of post-fundoplication patients with and without dysphagia with 50 healthy controls. High Intrabolus Pressure <57% Percent LES Relaxation >15 mmHg LES Residual Pressure >20mmHg Intrabolus Pressure Manometric signs of outflow obstruction 27 11 3 No Dysphagia p<0.001 94 17 16 Dysphagia 油 % Total # of Patients with Manometric Evidence of Outflow Obstruction (any of 3) 油 Two Distal High Pressure Zones (LES and Diaphragmatic Crura)