| Objective:To investigate the consistency between SHRM and WHRM in the esophageal functionand whether the Chicago classification based on SHRM system is suitable to the WHRM ornot.Methods:We performed both SHRM assembly with a36circumferential sensors spaced at1-cmintervals (Sierra Scientifc Instruments Inc. Los Angeles, CA, USA) and WHRM assemblywith22-channel water-perfused silicone rubber catheter (Medical Measurement systems, TheNetherlands) in the same group of Twenty-three healthy volunteers and fifteen patients on twoseparate days within one week. Subjects were studied in the supine position. They swallowed5ml of water and repeat this for a total of10times separated by30-s intervals, so did the solidswallow (2cm*2cm*2cm size of bread). Measurements of anatomical parameters such as theLES length in the abdomen, upper and lower edge locations from the nare of the LES andUES and so on, coupled with the biomechanics parameters for DCI,4sIRP, DL andcontraction amplitude of5cm above the LES for each swallow were compared.Results:(1) The UES anatomical structure was overidentified by WHRM comparing with SHRM; (2) The SRHM assembly provided significantly higher pressure values for esophagealperistalsis and oesophago-gastric junction whereas the WHRM assembly offered a little higherUES resting pressure with no significant difference;(3) The Bland–Altman plots showed thatresults from the two measurement methods could not be interchangeable in clinic;(4) If basedon the Chicago classification,the WHRM system will over-diagnose failed peristalsis, largeand small break contraction in wet swallow, and the WHRM missed6hypercontractilecontraction which were diagnosed by SHRM.Conclusions:Manometric results obtained using SHRM and WHRM assemblies are different andnot interchangeable clinically. The Chicago classification is not suitable to the WHRM system,so it is needed to establish esophageal motility disorders classifcation based on WHRMsystem. |
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