Durchführung und Interpretation der Ösophagusmanometrie: Empfehlungen der Deutschen Gesellschaften für Neurogastroenterologie und Motilität (DGNM), für Verdauungs- und Stoffwechselerkrankungen (DGVS) und für Allgemein- und Viszeralchirurgie (DGAV)

Zusammenfassung

Die Ösophagusmanometrie dient der Ableitung der Druckprofile des tubulären Ösophagus sowie seiner Sphinkteren in Ruhe sowie bei Schluckakten und spiegelt die kontraktile Aktivität der Speiseröhre wider. Sie gilt als Referenzverfahren zur Erfassung ösophagealer Motilitätsstörungen, wird aktuell aber in unterschiedlichen Zentren nicht einheitlich durchgeführt. Die vorliegende Arbeit gibt die Empfehlungen der Deutschen Gesellschaften für Neurogastroenterologie und Motilität (DGNM), für Verdauungs- und Stoffwechselerkrankungen (DGVS) und für Allgemein- und Viszeralchirurgie (DGAV) zur konventionellen Ösophagusmanometrie wieder. Dargestellt werden Indikationen, praktische Durchführung und Analyse der Ösophagusmanometrie jeweils mit erläuternder Hintergrundinformation. Der Artikel soll einerseits erfahrenen Kollegen als umfassende Übersichtsarbeit dienen und andererseits Unerfahrenen konkrete Anleitungen zur Durchführung und Auswertung der konventionellen Ösophagusmanometrie an die Hand geben. Darüber hinaus werden auch Empfehlungen zum Einsatz neuerer bzw. ergänzender diagnostischer Verfahren, nämlich der Langzeit- und hochauflösenden Manometrie sowie Impedanzmessung, gegeben.

Abstract

Esophageal manometry examines the pressure profiles of the tubular esophagus and of the esophageal sphincters during resting conditions and in response to swallowing. It is regarded as the reference method for detection of esophageal motility disturbances but, up to date, performance of the procedure is not standardized among centers. This review depicts the recommendations of the German Societies for Neurogastroenterology and Motility, for Digestive and Metabolic Disturbances and for General and Visceral Surgery on indications, performance and analysis of conventional esophageal manometry. In addition to concise recommendations we give detailed background information so that the article can serve as a practical guideline for inexperienced investigators as well as an exensive review for the experienced one. Moreover, recommendations on the use of newer and/or supplementary diagnostic techniques, that is long-term and high resolution manometry as well as esophageal impedance measurements are also given.

Schlüsselwörter

Motilitätsstörung - Achalasie - diffuser Ösophagusspasmus - hyperkontraktiler Ösophagus - Manometrie

Key words

motility disturbance - achalasia - diffuse esophageal spasm - hypercontractile esophagus - manometry

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