摘要
AIM:With successful surgical treatment of gastroesophageal reflux disease(GERD),there is interest in understanding the anti-reflux barrier and its mechanisms of failure.To date, the potential use of vector volumes to predict the DeMeester score has not been adequately explored. METHODS:627 patients in the referral database received esophageal manometry and ambulatory 24-hour pH monitoring.Study data included LES resting pressure(LESP), overall LES length(OL)and abdominal length(AL),total vector volume(TVV)and intrabdominal vector volume(IVV). RESULTS:In cases where LESP,TVV or IVV were all below normal,there was an 81.4%probability of a positive DeMeester score.In cases where all three were normal, there was an 86.9%probability that the DeMeester score would be negative.Receiver-operating characteristics(ROC) for LESP,TVV and IVV were nearly identical and indicated no useful cut-off values.Logistic regression demonstrated that LESP and IVV had the strongest association with a positive DeMeester score;however,the regression formula was only 76.1%accurate. CONCLUSION:While the indices based on TVV,IVV and LESP are more sensitive and specific,respectively,than any single measurement,the measurement of vector volumes does not add significantly to the diagnosis of GERD.
AIM: With successful surgical treatment of gastroesophagealreflux disease (GERD), there is interest in understandingthe anti-reflux barrier and its mechanisms of failure. To date,the potential use of vector volumes to predict the DeMeesterscore has not been adequately explored.METHODS: 627 patients in the referral database receivedesophageal manometry and ambulatory 24-hour pHmonitoring. Study data included LES resting pressure (LESP),overall LES length (OL) and abdominal length (AL), totalvector volume (TW) and intrabdominal vector volume (IVV).RESULTS: In cases where LESP, TVV or IVV were all belownormal, there was an 81.4 % probability of a positiveDeMeester score. In cases where all three were normal,there was an 86.9 % probability that the DeMeester scorewould be negative. Receiver-operating characteristics (ROC)for LESP, TW and IW were nearly identical and indicatedno useful cut-off values. Logistic regression demonstratedthat LESP and IVV had the strongest association with apositive DeMeester score; however, the regression formulawas only 76.L % accurate.CONCLUSION: While the indices based on TVV, IW andLESP are more sensitive and specific, respectively, than anysingle measurement, the measurement of vector volumesdoes not add significantly to the diagnosis of GERD.
