J Neurogastroenterol Motil.  2021 Jul;27(3):347-353. 10.5056/jnm20217.

Variations in Clinical Practice of Esophageal High-resolution Manometry: A Nationwide Survey

• Gong EJ
• Choi SI
• Lee BE
• Min YW
• Cho YK
• Jung KW
• Kim JH
• Park MI
• Dysphagia Study Group Under the Korean Society of Neurogastroenterology and Motility

• KMID: 2517528
• DOI: http://doi.org/10.5056/jnm20217

Abstract

Background/Aims
Esophageal high-resolution manometry (HRM) enables the comprehensive evaluation of the esophageal motor function. However, protocols are not uniform and clinical practices vary widely among institutions. This study aims to understand the current HRM practice in Korea.
Methods
The survey was sent via email through the Korean Society of Neurogastroenterology and Motility. The questions covered descriptive information, preparation, techniques, analysis, and reporting of esophageal HRM.
Results
The survey was completed in 32 (74.4%) out of 43 centers, including 24 tertiary and 8 secondary referral centers. Of the 32 centers, 25 (78.1%) performed HRM in a sitting position, while 7 centers (21.9%) reported performing HRM in a supine position. All the centers utilized single wet swallows as a standard, but the volume, frequency, and interval between swallows varied widely. Sixteen centers (50.0%) applied adjunctive tests, including multiple rapid swallows (n = 16) and rapid drink challenges (n = 9). Parameters assessed and documented in the report were similar. In addition to the assessment of the esophagogastric junction and esophageal body, 27 centers (84.8%) and 18 centers (56.3%) included measurements for the upper esophageal sphincter and the pharynx, respectively, in the HRM protocol.
Conclusions
We found a variation in the available HRM practice among centers, even though they broadly agreed in the data analysis. Efforts are needed to develop a standardized protocol for HRM measurement.

Keyword

Clinical practice pattern; Esophageal motility disorders; Manometry