ArticleNeurogastroenterology and motility2026
Diagnostic Accuracy of High-Resolution Manometry for Assessing Fundoplication Integrity: Validation of the Padova Classification.
Article in Neurogastroenterology and motility, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRecurrent symptoms after laparoscopic fundoplication (LF) are not fully understood, with ongoing research focusing on their mechanisms. This study aimed to validate the Padova Classification, a postoperative high-resolution manometry (HRM) framework to distinguish functioning from defective fundoplications.
methodsProspectively collected data from consecutive patients who underwent post-LF HRM (2010-2025) were analyzed and categorized as functioning and effective LF (FELF), post-fundoplication outflow obstruction (PFOO), and ineffective neo-barrier (INB). Primary analysis involved between-group comparisons. Padova Classification diagnostic accuracy was evaluated against a composite reference standard (clinical, radiological, endoscopic, and pH-monitoring criteria) by calculating sensitivity, specificity, positive predictive value, and negative predictive value for each diagnostic category. Diagnostic performance of postoperative integrated relaxation pressure (IRP) for identifying PFOO was evaluated using receiver operating characteristic curve analysis. KEY
resultsAmong 373 patients (42.4% female; median age 54 years, median BMI 25.9 kg/m
conclusionsThis study confirms that the Padova Classification demonstrates strong performance in assessing postoperative LF function.
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