Evidence map›Paper›PMID 30251140›Full record

ArticleSurgical endoscopy2019

Routine esophageal manometry is not useful in patients with normal videoesophagram.

Evan T Alicuben, Nikolai Bildzukewicz, Kamran Samakar, Namir Katkhouda, Adrian Dobrowolsky, Kulmeet Sandhu, John C Lipham

Abstract read
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Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Evan T AlicubenDivision of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1510 San Pablo St. #514, Los Angeles, CA, 90033, USA.
Nikolai BildzukewiczDivision of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1510 San Pablo St. #514, Los Angeles, CA, 90033, USA.
Kamran SamakarDivision of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1510 San Pablo St. #514, Los Angeles, CA, 90033, USA.
Namir KatkhoudaDivision of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1510 San Pablo St. #514, Los Angeles, CA, 90033, USA.
Adrian DobrowolskyDivision of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1510 San Pablo St. #514, Los Angeles, CA, 90033, USA.
Kulmeet SandhuDivision of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1510 San Pablo St. #514, Los Angeles, CA, 90033, USA.
John C LiphamDivision of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1510 San Pablo St. #514, Los Angeles, CA, 90033, USA. john.lipham@med.usc.edu.
University of Southern California · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVideoesophagram (VEG) and esophageal manometry (EM) are components of the preoperative evaluation for foregut surgery. EM is able to identify motility disorders and diminished contractility that may alter surgical planning. However, there are no clearly defined criteria to guide this. Reliable manometry is not always easily obtained, and therefore its necessity in routine preoperative evaluation is unclear. We hypothesized that if a patient has normal videoesophagram, manometry does not reveal clinically significant esophageal dysfunction.

methodsWe reviewed patients who underwent protocolized videoesophagram and manometry at our institution. Measures of esophageal motility including the mean distal contractile integral (DCI), mean wave amplitude (MWA), and percent of peristaltic swallows (PPS) were analyzed. The Chicago Classification was used for diagnostic criteria of motility disorders. Normal VEG was defined as stasis of liquid barium on less than three of five swallows.

resultsThere were 418 patients included. 231 patients (55%) had a normal VEG, and 187 patients (45%) had an abnormal VEG. In the normal VEG group, only 2/231 (0.9%) patients had both abnormal DCI and PPS, 1/231 (0.4%) patients had both abnormal DCI and MWA and no patients had both abnormal MWA and PPS. There were no patients with achalasia or absent contractility and 1 patient with ineffective esophageal motility (IEM) in the normal VEG group. This was significantly different from the abnormal VEG group which included 4 patients with achalasia, 1 with absent contractility and 22 with IEM (p < 0.0001). The negative predictive value of VEG was 99.6% and the sensitivity was 96.4%.

conclusionsA normal videoesophagram reliably excluded the presence of clinically significant esophageal dysmotility that would alter surgical planning. Routine manometry is not warranted in patients with normal videoesophagram, and should be reserved for patients with abnormal VEG.

Indexed as

AdultEsophageal AchalasiaEsophageal Motility DisordersFemaleHumansMaleManometryMiddle AgedVideo RecordingEsophageal motilityHigh-resolution manometryVideoesophagram

Identifiers

PMID30251140
OpenAlexW2893092750

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.