{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T08:01:06Z","timestamp":1764403266409,"version":"3.37.3"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008891","name":"Loma Linda University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008891","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>High-resolution manometry (HRM) is vital in evaluating patients for surgery at the gastroesophageal (GE) junction. Previously, we reported manometry alters surgery choices at the GE junction over 50% of the time, and its components, i.e., abnormal motility and distal contractile integral (DCI), are vital in decision-making. This single-institution retrospective study examines how HRM characteristics, reported with the Chicago classification, can alter the intended surgical plans for foregut surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We collected data on pre-operative symptoms for patients undergoing HRM studies from 2012 to 2016, i.e., Upper GI X-rays, 48-h pH studies, DeMeester scores, upper endoscopy, and biopsy reports. HRM results were further categorized via Chicago classification (i.e., normal or abnormal motility). The DCI was determined; Patients not seen by a surgeon were excluded. Then a single surgeon, blinded to patient identity and HRM results, determined the planned procedure. The reviewer was then exposed to the HRM results; procedural plans were revised if needed. HRM results were then evaluated to determine which factors most influenced the surgical decisions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>298 HRM studies were initially identified; 114 met search criteria. Overall, HRM altered the planned procedure in 50.9% of cases (<jats:italic>n<\/jats:italic>\u2009=\u200958), with abnormal motility in 54.4% (62\/114) cases. Abnormal motility findings corresponded to 70.6% (41\/58) of the patients in which HRM changed the surgery decision. A DCI of\u2009&lt;\u20091000 was identified in only 31.6% (36\/114) of all patients, but 39.7% (23\/58) of cases where the surgical decision was altered. A DCI of\u2009&gt;\u20095000 was identified in only 10.5% (12\/114) of all patients but 10.3% (6\/58) of cases with altered surgical decisions. A DCI\u2009&lt;\u20091000 and abnormal motility were generally associated with a partial fundoplication.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study demonstrates the impact of identifying abnormal motility via the Chicago classification and factors like DCI on surgical choice at the GE junction.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-023-10161-3","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T18:02:27Z","timestamp":1687802547000},"page":"7060-7063","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Components of high-resolution manometry that change surgical decisions"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0541-7086","authenticated-orcid":false,"given":"Georg","family":"Wiese","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Delgado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irteza","family":"Inayat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Eubanks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"10161_CR1","doi-asserted-by":"publisher","first-page":"301","DOI":"10.14309\/ajg.000000000000073","volume":"2","author":"R Yadlapati","year":"2017","unstructured":"Yadlapati R (2017) High-resolution esophageal manometry: interpretation in clinical practice. Curr Opin Gastroenterol 2:301\u2013309. https:\/\/doi.org\/10.14309\/ajg.000000000000073","journal-title":"Curr Opin Gastroenterol"},{"key":"10161_CR2","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1053\/j.gastro.2008.05.048","volume":"135","author":"PJ Kahrilas","year":"2008","unstructured":"Kahrilas PJ, Sifrim D (2008) High-resolution manometry and impedance-pH\/manometry: valuable tools in clinical and investigational esophagology. Gastroenterology 135:756\u2013769. https:\/\/doi.org\/10.1053\/j.gastro.2008.05.048","journal-title":"Gastroenterology"},{"key":"10161_CR3","first-page":"249","volume":"9","author":"R Tatum","year":"2013","unstructured":"Tatum R (2013) Pre-operative esophageal evaluation of patients being considered for anti-reflux surgery. Gastroenterol Hepatol 9:249\u2013251","journal-title":"Gastroenterol Hepatol"},{"key":"10161_CR4","doi-asserted-by":"publisher","first-page":"2943","DOI":"10.1007\/s00464011-1646-9","volume":"25","author":"W Chan","year":"2011","unstructured":"Chan W, Haroian LR, Gyawali CP (2011) Value of pre-operative esophagus function studies before laparoscopic anti-reflux surgery. Surg Endosc 25:2943\u20132949. https:\/\/doi.org\/10.1007\/s00464011-1646-9","journal-title":"Surg Endosc"},{"key":"10161_CR5","doi-asserted-by":"publisher","first-page":"e14058","DOI":"10.1111\/nmo.14058","volume":"33","author":"R Yadlapati","year":"2021","unstructured":"Yadlapati R, Kahrilas PJ, Fox MR, Bredenoord AJ, Prakash Gyawali C, Roman S, Babaei A, Mittal RK, Rommel N, Savarino E, Sifrim D, Smout A, Vaezi MF, Zerbib F, Akiyama J, Bhatia S, Bor S, Carlson DA, Chen JW, Cisternas D, Cock C, Coss-Adame E, de Bortoli N, Defilippi C, Fass R, Ghoshal UC, Gonlachanvit S, Hani A, Hebbard GS, Wook Jung K, Katz P, Katzka DA, Khan A, Kohn GP, Lazarescu A, Lengliner J, Mittal SK, Omari T, Park MI, Penagini R, Pohl D, Richter JE, Serra J, Sweis R, Tack J, Tatum RP, Tutuian R, Vela MF, Wong RK, Wu JC, Xiao Y, Pandolfino JE (2021) Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0\u00a9. 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