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AIM:With successful surgical treatment of gastroesophagealreflux disease(GERD),there is interest in understandingthe anti-reflux barrier and its mechanisms of failure.To date,the potential use of vector volumes to predict the DeMeesterscore has not been adequately explored.METHODS:627 patients in the referral database receivedesophageal manometry and ambulatory 24-hour pHmonitoring.Study data included LES resting pressure(LESP),overall LES length(OL)and abdominal length(AL),totalvector volume(TVV)and intrabdominal vector volume(IVV).RESULTS:In cases where LESP,TVV or IVV were all belownormal,there was an 81.4%probability of a positiveDeMeester score.In cases where all three were normal,there was an 86.9%probability that the DeMeester scorewould be negative.Receiver-operating characteristics(ROC)for LESP,TVV and IVV were nearly identical and indicatedno useful cut-off values.Logistic regression demonstratedthat LESP and IVV had the strongest association with apositive DeMeester score;however,the regression formulawas only 76.1%accurate.CONCLUSION:While the indices based on TVV,IVV andLESP are more sensitive and specific,respectively,than anysingle measurement,the measurement of vector volumesdoes not add significantly to the diagnosis of GERD.
AIM: With successful surgical treatment of gastroesophageal reflux disease (GERD), there is interest in understanding the anti-reflux barrier and its mechanisms of failure. To date, the potential use of vector volumes to predict the DeMeesterscore has not been adequately exploded. METHODS: 627 patients in the referral database receive desophageal manometry and ambulatory 24-hour pHmonitoring. Study data included LES resting pressure (LESP), overall LES length (OL) and abdominal length (AL), total vector volume (TVV) and intrabdominal volume (IVV). RESULTS: In cases where LESP, TVV or IVV were all belownormal, there was an 81.4% probability of a positiveDeMeester score.In cases where all three were normal, there was an 86.9% probability that the DeMeester scorewould be negative. Receiver-operating characteristics (ROC) for LESP, TVV and IVV were nearly identical and indicated no useful cut-off values. Logistic regression demonstrated that LESP and IVV had the strongest association with a positive event DeMeester score; ho wever, the regression formula was only 76.1% accurate. CONCLUSION: While the indices based on TVV, IVV andLESP are more sensitive and specific, respectively, than an one-shot measurement, the measurement of vector volumes does not add significantly to the diagnosis of GERD.