Comparison of Solid State and Water Perfusion Catheters in Functional Esophagus Diseases in Esophageal Motility Process
Project no. 160 · Status: Kapanmış · 2018
Summary
High resolution manomety (HRM) is performed with solid-state catheters (SS) in many centers. However according to Chicago classification, very limited data from healthy volunteers are available for some catheters and starting from IRP, numerical values are crucial for the diagnosis. Because of the cost of the SS-HRM catheters many centers especially from developing countries use water perfusion HRM (W-HRM) catheters up to 24 channels and normal values are even more limited. We evaluated a prototype 36 channels W-HRM reused catheter allowing to measure 3-D pressure vector volume analysis of lower esophageal sphincter in healthy volunteers and compared to 36 channels SS-HRM catheters (Laborie-MMS, Canada). We included 43 healthy volunteers without any upper gastrointestinal complaint. Upper gastrointestinal endoscopy and 24h impedance-pH monitoring performed in all subjects. Four subjects were excluded because of silent GERD. 39 subjects were analysed (25 males, W-HRM (n=39), SS-HRM (n=33)(MMS Laborie Unisensor, Canada). Thirtythree patients underwent two esophageal manometry studies within two consecutive days with a random order. Procedures were performed in supine position with receiving ten times 5ml water, multiple water swallow with 200ml and five times solid food. 36 channel water- perfused 3-D HRM catheter and 36 channel solid state HRM catheter were used. There was significant differences between two catheters in terms of Integrated Relaxation Pressure (IRP), Distal Contractile Integrale (DCI) and DCI- expanded, LES resting pressure, % of ineffective peristalsis, and esophageal length both with water and solid food swallows. No difference has been shown with distal latency (DL), LES length, breaks size. Water perfusion HRM catheter exhibits significantly lower values especially for IRP, DCI, LES resting pressure. The ineffective peristalsis pattern is common with water perfusion catheters. Centers which are working with water perfusion catheters should not accept universal normal established values with solid state catheters and should detect on their normative values.