Technical Success in Performing Esophageal High-Resolution Manometry in Patients with an Epiphrenic Diverticulum

Cohen, Daniel L.; Bermont, Anton; Richter, Vered; Avivi, Eyal; Mari, Amir; Shirin, Haim

doi:10.1007/s00455-023-10610-0

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…Future studies are warranted to explore this strategy. This study reinforces associations between achalasia and LES traversal failure, as similar rates are reported in this study to that performed by Hengehold et al 9 This study reinforces the association between ED and LES traversal failure described by Cohen et al, 10 and this study does so with consecutive patients.…”

Section: Discussionsupporting

confidence: 92%

“…8,9 Failure to pass the lower esophageal sphincter (LES) or full EGJ with the HREM catheter has been associated with structural abnormalities of the esophagus causing obstruction, like large hiatal hernias, epiphrenic diverticula (ED), and achalasia in different studies. 9,10 In these patients, esophageal motility evaluation must be made with different studies. Alternatives include HREM catheter placement with EGD assistance, endoscopic functional lumen imaging probe (FLIP), or barium esophagram.…”

Section: Introductionmentioning

confidence: 99%

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Nasopharyngeal airway assistance improves esophageal intubation rates of high‐resolution esophageal manometry catheters

Leopold,

Wu,

Xie

2024

Neurogastroenterology Motil

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BackgroundHigh‐resolution esophageal manometry (HREM) is the gold standard test for esophageal motility disorders. Nasopharyngeal airway‐assisted insertion of the HREM catheter is a suggested salvage technique for failure from the inability to pass the catheter through the upper esophageal sphincter (UES). It has not been demonstrated that the nasopharyngeal airway improves procedural success rate.MethodsPatients undergoing HREM between March 2019 and March 2023 were evaluated. Chart review was conducted for patient factors and procedural success rates before and after use of nasopharyngeal airway. Patients from March 2019 to May 2021 did not have nasopharyngeal airway available and were compared to patients from May 2021 to March 2023 who had the nasopharyngeal airway available.Key ResultsIn total, 523 HREM studies were conducted; 234 occurred prior to nasopharyngeal airway availability, and 289 occurred with nasopharyngeal airway availability. There was no difference in HREM catheter UES intubation rates between periods when a nasopharyngeal airway attempt was considered procedural failure (85% vs. 85%, p = 0.9). Nasopharyngeal airway use after UES intubation failure lead to improved UES intubation rates (94% vs. 85%, p < 0.01). Thirty‐six patients that failed HREM catheter UES intubation had the procedure reattempted with a nasopharyngeal airway, 30 (83%) of which were successful. The nasopharyngeal airway assisted catheter UES intubation for failures attributed to nasal pain and hypersensitivity, gagging, coughing, and pharyngeal coiling.Conclusions & InferencesUtilization of the nasopharyngeal airway increased rates of UES intubation. When HREM catheter placement through the UES fails, placement of a nasopharyngeal airway can be trialed to overcome patient procedural intolerance.

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Section: Discussionsupporting

confidence: 92%