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• W1440658534 abstract "While colonic manometry has helped to defined dysmotility in patients with functional colonic or anorectal disorders, identification of specific manometric markers that assist in subtyping these disorders remains elusive. Typically colonic manometry is recorded with sensor spacing ≥10cm, however we have shown that colonic propagated sequences (PS) can extend over segments as short as 3-5cm(1). It is likely, therefore that traditional manometry is overlooking potentially relevant motor patterns. Aim: To determine the influence of pressure sensor spacing on our ability to accurately identify colonic motility patterns. Method: A fibre-optic catheter containing 72-90 sensors spaced at 1cm intervals was placed colonoscopically to the caecum in 11 patients with scintigraphically confirmed slow transit constipation. Controls comprised 11 patients with neurogenic fecal incontinence and 9 healthy subjects. From each of these recordings a 2hr section of trace was selected to assess motor response to either the response to a 1000kCal meal (healthy controls) or the colonic response to sacral nerve stimulation (patient population). Each data set was analysed in 6 different ways by sub-sampling different sets of the full array to simulate inter-recording site distances of 10, 7, 5, 3, 2 and 1cm. In blinded fashion, in each manometric trace antegrade and retrograde propagating sequences (PS) were identified. Against the 1cm spaced data (gold standard), we compared all the PSs identified at each test sensor spacing (2-10cm). Results: In all three groups as sensor spacing increased; i) the frequency of identified antegrade and retrograde PSs decreased; , 5% of the propagating activity observed at 1cm spacing could be seen at 10cm (P , 0.0001); ii) the ratio of antegrade to retrograde PSs increased (P , 0.0001), from pre-dominantly retrograde activity at 1cm spacing to predominantly antegrade at 10cm spacing; & iii) the number of falsely labeled PSs (when compared to 1cm data) increased (P , 0.003). At a sensor spacing .5cm the only PSs that can be reliably detected are those of high amplitude and slow propagation velocity; (real vs false amplitude: 138 vs 29 (+/12 SEM) mmHg; real vs false velocity: 5 vs 20 (+/3 SEM) mm/s). Conclusions: 1) Inadequate proximity between recording sites (resolution) results in both missed and mis-labeling of colonic propagating sequences. 2) An inter-recording site distance . 5cm grossly misrepresents colonic manometric patterns. 3) High resolution colonic manometry is likely to assist in the identification of diagnostically relevant manometric markers of colonic motor disorders. Supported by NHMRC and CSIRO Australia (1) Dinning PG et al. Br J Surg. 99: 1002-1010." @default.
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• W1440658534 date "2013-05-01" @default.
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• W1440658534 title "Tu2069 Characterization of the Colonic Meal Response in Healthy Controls and Patients With Slow Transit Constipation: Initial Results From Fibre-Optic High-Resolution Manometry" @default.
• W1440658534 doi "https://doi.org/10.1016/s0016-5085(13)63425-3" @default.
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