Reaction to Articles on High Resolution Manometry, the Length of the Lower Esophageal Sphincter and the Diagnosis of Gastroesophageal Reflux Disease

Levin, Michael D

doi:10.1590/s0004-2803.201900000-39

Cited by 1 publication

(1 citation statement)

References 6 publications

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“…Furthermore, all these measurements in children based on manometry record the distance to the upper margin of the LES rather than the actual EGJ and do not acknowledge that the LES is a region and not a point. The LES is a high‐pressure zone that lengthens with age, measuring 1‐3 cm in children and 3–5 cm in adults (Levin, 2019).…”

Section: Discussionmentioning

confidence: 99%

Esophageal length in children: Reference data and a novel predictive equation

Tinawi

Stringer

2021

Clinical Anatomy

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Minimal information exists on the length of the child's esophagus, namely the distance from the cricopharyngeus to the esophagogastric junction (EGJ). We aimed to investigate the relationship between esophageal length (EL) and the age, height, and weight of the child. Children undergoing upper gastrointestinal endoscopy between February 2019 and May 2021 at our institution were prospectively audited. Children with anatomical esophageal disorders were excluded. Endoscopic distances from the incisors to the cricopharyngeus and EGJ were obtained, and novel predictive equations derived to predict EL. Intra‐observer agreement for endoscopic measurements showed an intra‐class correlation coefficient of 0.99. A total of 290 children aged 0.4–17.3 years were included in the analysis; they were divided into a model development cohort (n = 261) and a model validation cohort (n = 29). Measured EL correlated best with height (r = 0.92) as compared to age (r = 0.90) or weight (r = 0.83). The optimal equation for predicting EL was 0.156 × height (cm) – 1.336 (adjusted R2 = 0.841); this had a success rate of 76% in the validation cohort. The optimal equation for predicting distance from incisors to EGJ was 0.199 × height (cm) + 6.470 (adjusted R2 = 0.889); this had a success rate of 69% in the validation cohort. This is the first study to report a predictive equation for estimating esophageal length in children. Accurate prediction of esophageal length may assist with clinical esophageal procedures in children such as nasogastric and pH probe placement.

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Section: Discussionmentioning

confidence: 99%