Accurate placement of the esophageal pH electrode for 24-hour pH monitoring using a combined pH/manometry probe
| Autor: | Peter C. O'Brien, Diane M. Davis, Kenneth R. DeVault, Paul J. Klingler, Sami R. Achem, Matthias H. Seelig, Ronald A. Hinder, Gerold J. Wetscher |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Manometry pH meter otorhinolaryngologic diseases medicine Humans Esophagus Electrodes Aged Monitoring Physiologic Hepatology medicine.diagnostic_test business.industry Esophageal disease Stomach Gastroenterology Equipment Design Gastric Acidity Determination Hydrogen-Ion Concentration Middle Aged medicine.disease Catheter medicine.anatomical_structure Anesthesia Electrode Esophageal sphincter Gastroesophageal Reflux Female Esophagogastric Junction Nuclear medicine business Esophageal pH monitoring |
| Zdroj: | The American journal of gastroenterology. 95(4) |
| ISSN: | 0002-9270 |
| Popis: | Accurate placement of a pH electrode requires manometric localization of the lower esophageal sphincter (LES). Combined manometry/pH devices using water-perfused tubes attached to pH catheters and the use of an electronic "LES locator" have been reported. We investigated whether accurate placement of pH probes can be achieved using such a probe, and whether this may reduce the need for the performance of the usual stepwise pull-back manometry.Thirty consecutive patients (15 men, 15 women; median age, 56 yr; interquartile range, 42-68 yr) referred for manometry and pH testing were included in the study. The localization of the LES was determined with standard esophageal manometry. After that, a second 3-mm pH electrode with an internal perfusion port was passed into the stomach. Using this catheter, a single stepwise pull-through manometry was performed and the LES position was noted. LES location, mean pressure, and length obtained with standard manometry were compared to data from the combined pH/manometry catheter. Additionally the time necessary to perform each of the procedures was noted and the patient's discomfort caused by the catheter was evaluated using a standardized questionnaire.The LES location with the pH/manometry probe was proximal to that with standard manometry in 19 patients (63%), the same in nine patients (30%), and distal in two patients (7%). The differences were2 cm in 29 of 30 (97%) patients. The LES location with the pH/manometry probe required a median of 6.5 min (interquartile range: 3.5-8.5 min) versus a median of 21.5 min (interquartile range: 14.5-26.5 min) for standard manometry (p0.0001). In addition, LES evaluation using the combined pH/manometry probe provided accurate data on the resting pressure, as well as overall and intraabdominal length of the LES. All patients tolerated the combination probe better than the standard manometry probe (p0.001).Placement of the esophageal electrode for 24-h esophageal pH monitoring using a combined pH/manometry probe is accurate. The technique is simple, time-saving, and convenient for the patients. Because it is possible to accurately evaluate the LES using this technique, it may even replace conventional manometry before pH probe placement. |
| Databáze: | OpenAIRE |
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