{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:26:43Z","timestamp":1790278003044,"version":"4.1.0"},"reference-count":16,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,10,6]],"date-time":"2024-10-06T00:00:00Z","timestamp":1728172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: Esophageal high-resolution manometry (HRM) is the gold standard for diagnosing esophageal motility disorders, but it may be poorly tolerated and unsuccessful. We sought to evaluate a protocol for sedation and endoscopy-assisted (SEA) HRM in patients who previously failed standard HRM and assess patient perspectives towards it. Methods: Adult patients who previously failed HRM were prospectively enrolled. Under propofol sedation, an upper endoscopy was performed during which the HRM catheter was advanced under endoscopic visualization. If the catheter did not reach the stomach on its own, the endoscope itself or a snare was used to help it traverse the esophagogastric junction (EGJ). Results: Thirty patients participated (mean age 67.8, 70% female). The technical success of SEA-HRM was 100%. Twenty-two (73.3%) were diagnosed with a motility disorder including thirteen (43.3%) with achalasia. Eighteen (60%) had previously failed HRM due to discomfort\/intolerance, while twelve (40%) failed due to catheter coiling in the esophagus. Subjects in the coiling group were more likely to need endoscopic assistance to traverse the EGJ (91.7% vs. 27.7%, p = 0.001) and have a motility disorder (100.0% vs. 55.6%, p = 0.010), including achalasia (75.0% vs. 22.2%, p = 0.004), compared to the discomfort\/intolerance group. All patients preferred SEA-HRM and rated it higher than standard HRM (9.5 \u00b1 1.3 vs. 1.9 \u00b1 2.1, p = &lt;0.001, on a scale of 1\u201310). Conclusions: SEA-HRM is a highly successful and well-tolerated option in patients who previously failed standard HRM. This should be the recommended approach in cases of failed HRM rather than secondary tests of esophageal motility.<\/jats:p>","DOI":"10.3390\/diagnostics14192232","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T07:08:18Z","timestamp":1728284898000},"page":"2232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sedation and Endoscopy-Assisted High-Resolution Manometry (SEA-HRM) in Patients Who Previously Failed Standard Esophageal Manometry"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7879-3966","authenticated-orcid":false,"given":"Daniel L.","family":"Cohen","sequence":"first","affiliation":[{"name":"The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin 70300, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Avivi","sequence":"additional","affiliation":[{"name":"The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin 70300, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergei","family":"Vosko","sequence":"additional","affiliation":[{"name":"The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin 70300, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6003-9220","authenticated-orcid":false,"given":"Vered","family":"Richter","sequence":"additional","affiliation":[{"name":"The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin 70300, Israel"},{"name":"The Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 61390, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haim","family":"Shirin","sequence":"additional","affiliation":[{"name":"The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin 70300, Israel"},{"name":"The Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 61390, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1343-8779","authenticated-orcid":false,"given":"Anton","family":"Bermont","sequence":"additional","affiliation":[{"name":"The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin 70300, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e14058","DOI":"10.1111\/nmo.14058","article-title":"Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0\u00a9","volume":"33","author":"Yadlapati","year":"2021","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"doad013","DOI":"10.1093\/dote\/doad013","article-title":"Technical success in performing esophageal high-resolution manometry: A review of competency recommendations, predictors of failure, and alternative techniques","volume":"36","author":"Cohen","year":"2023","journal-title":"Dis. Esophagus"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/j.cgh.2011.08.007","article-title":"High-resolution manometry studies are frequently imperfect but usually still interpretable","volume":"9","author":"Roman","year":"2011","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e14273","DOI":"10.1111\/nmo.14273","article-title":"Imperfect high-resolution manometry studies: Prevalence and predictive factors","volume":"34","author":"Hengehold","year":"2021","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1007\/s10388-021-00875-5","article-title":"Characteristics of patients with esophageal motility disorders on high-resolution manometry and esophagography\u2014A large database analysis in Japan","volume":"19","author":"Sato","year":"2021","journal-title":"Esophagus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2943","DOI":"10.1007\/s00464-011-1646-9","article-title":"Value of preoperative esophageal function studies before laparoscopic antireflux surgery","volume":"25","author":"Chan","year":"2011","journal-title":"Surg. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.14309\/ajg.0000000000000773","article-title":"Use of the Functional Lumen Imaging Probe in Clinical Esophagology","volume":"115","author":"Savarino","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"352","DOI":"10.5056\/jnm20006","article-title":"Performing High-resolution Impedance Manometry After Endoscopy With Conscious Sedation Has Negligible Effects on Esophageal Motility Results","volume":"26","author":"Su","year":"2020","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_9","first-page":"9720243","article-title":"Endoscopy- and Monitored Anesthesia Care-Assisted High-Resolution Impedance Manometry Improves Clinical Management","volume":"2018","author":"Christian","year":"2018","journal-title":"Case Rep. Gastrointest. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"157","DOI":"10.14740\/gr1185","article-title":"Revisiting the Reliability of the Endoscopy and Sedation-Assisted High-Resolution Esophageal Motility Assessment","volume":"12","author":"Tariq","year":"2019","journal-title":"Gastroenterol. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1097\/MCG.0b013e3182098bcd","article-title":"Endoscopically assisted water perfusion esophageal manometry with minimal sedation: Technique, indications, and implication on the clinical management","volume":"45","author":"Brun","year":"2011","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_12","first-page":"e10063","article-title":"Roth Net-Assisted Endoscopic-Guided Manometry Catheter Placement","volume":"12","author":"Gurala","year":"2020","journal-title":"Cureus"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e14379","DOI":"10.1111\/nmo.14379","article-title":"Guidewire-assisted placement of water-perfused esophageal high-resolution manometry probe when gastric insertion fails: A single-center experience","volume":"34","author":"Delbaen","year":"2022","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1213\/00000539-197011000-00020","article-title":"A postanesthetic recovery score","volume":"49","author":"Aldrete","year":"1970","journal-title":"Anesth Analg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/s00455-023-10610-0","article-title":"Technical Success in Performing Esophageal High-Resolution Manometry in Patients with an Epiphrenic Diverticulum","volume":"39","author":"Cohen","year":"2024","journal-title":"Dysphagia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e14824","DOI":"10.1111\/nmo.14824","article-title":"Nasopharyngeal airway assistance improves esophageal intubation rates of high-resolution esophageal manometry catheters","volume":"36","author":"Leopold","year":"2024","journal-title":"Neurogastroenterol. Motil."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/19\/2232\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:11:51Z","timestamp":1760112711000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/19\/2232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,6]]},"references-count":16,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["diagnostics14192232"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14192232","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,6]]}}}