ArticleUnited European gastroenterology journal2018
High-resolution manometry is superior to endoscopy and radiology in assessing and grading sliding hiatal hernia: A comparison with surgical in vivo evaluation.
Article in United European gastroenterology journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 78 citations in OpenAlex.
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- ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing.The American journal of gastroenterology · 2020Guideline
- Preoperative Esophageal Physiologic Testing in Bariatric Surgery: How Far Should We Go?Journal of neurogastroenterology and motility · 2026Article
- Gatherings in Esophagology: Innovations and Future Directions in the Diagnosis and Management of Reflux Disease.Annals of the New York Academy of Sciences · 2026Article
- The Milan Score Predicts Objective Gastroesophageal Reflux Disease in Patients With Type 2 Esophagogastric Junction.Neurogastroenterology and motility · 2026Article
- The "ABCD" framework for assessment: a task-oriented approach to reconcile multimodal diagnostic discordance.Frontiers in medicine · 2026Review
- Pathophysiology of Gastroesophageal Reflux Disease.Digestion · 2026Review
- Diagnosis of Sliding Hiatal Hernia in Patients With Morbid Obesity: A Comparison of High-resolution Esophageal Manometry and Upper Gastrointestinal Series.Journal of neurogastroenterology and motility · 2025Article
- Hiatal Hernias Revisited-A Systematic Review of Definitions, Classifications, and Applications.Life (Basel, Switzerland) · 2024Review
- Utilizing Esophageal Motility Tests in Diagnosing and Evaluating Gastroesophageal Reflux Disease.Diagnostics (Basel, Switzerland) · 2024Review
- Management of gastro-esophageal reflux disease: Practice-oriented answers to clinical questions.World journal of gastroenterology · 2023Review
- Identifying hiatal hernia with impedance planimetry during esophageal distension testing.Neurogastroenterology and motility · 2023Article
- A multi-stage machine learning model for diagnosis of esophageal manometry.Artificial intelligence in medicine · 2022Article
- Chicago Classification update (v4.0): Technical review of high-resolution manometry metrics for EGJ barrier function.Neurogastroenterology and motility · 2021Article
- Accuracy of High-Resolution Manometry in Hiatal Hernia Diagnosis in Primary and Revision Bariatric Surgery.Obesity surgery · 2021Article
- Preoperative physiological esophageal assessment for anti-reflux surgery: A guide for surgeons on high-resolution manometry and pH testing.World journal of gastroenterology · 2021Review
- Hiatal hernia prevalence and natural history on non-contrast CT in the Multi-Ethnic Study of Atherosclerosis (MESA).BMJ open gastroenterology · 2021Article
- A deep-learning-based unsupervised model on esophageal manometry using variational autoencoder.Artificial intelligence in medicine · 2021Article
- Analysis of the Risk Factors for Hypotension in Laparoscopic Hiatal Hernia Repair.International journal of general medicine · 2021Article
- Pharmacological Management of Gastro-Esophageal Reflux Disease: An Update of the State-of-the-Art.Drug design, development and therapy · 2021Review
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHiatal hernia is diagnosed by barium-swallow esophagogram or esophagogastroduodenoscopy, with possible suboptimal results. High-resolution manometry clearly identifies crural diaphragm and lower esophageal sphincter.
objectivesTo assess the diagnostic accuracy of high-resolution manometry in detecting hiatal hernia compared to esophagogram and esophagogastroduodenoscopy, using as reference the surgical in vivo measurement.
methodsPatients were studied with esophagogram, esophagogastroduodenoscopy, high-resolution manometry and in vivo evaluation of the esophago-gastric junction. Esophago-gastric junction was classified as type I (no separation between crural diaphragm and lower esophageal sphincter); type II (≥1, ≤ 2 cm separation); type III (>2 cm). During in vivo measurement, distance between the esophago-gastric junction and crural diaphragm proximal border was recorded.
resultsSurgery identified 53 hiatal hernias in 100 patients. Forty-seven percent were classified as type I esophago-gastric junction, 35% type II and 18% type III. Referenced to in vivo evaluation, high-resolution manometry showed superior diagnostic sensitivity and specificity (94.3% and 91.5%, respectively) to esophagogram and esophagogastroduodenoscopy, with 92.6% predictive value of a positive test and 93.5% predictive value of a negative test. The kappa value for high-resolution manometry and in vivo evaluation was 0.85. High-resolution manometry showed optimal sensitivity and specificity in detecting types I, II and III esophago-gastric junction.
conclusionsHigh-resolution manometry enables an accurate diagnosis of hiatal hernia and a better classification than endoscopy and radiology, reaching optimal agreement with in vivo assessment.
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