Abstract Background The esophagogastric junction contractile integral (EGJ-CI) is a manometric parameter used to assess EGJ function. EGJ-CI must be manually calculated using a multi-step process. An earlier metric, the lower esophageal sphincter pressure integral (LESPI), is conceptually similar to EGJ-CI, but has a more straightforward calculation algorithm. Aims This study aimed at proposing a new, easier to calculate metric, the modified EGJ-CI (m-EGJ-CI) and to compare its fidelity to EGJ-CI. Methods After Institutional Review Board (IRB) approval, we conducted a cross-sectional study. High-resolution manometry studies performed between February 2018 and October 2024 at our center were retrieved. Patients with prior foregut procedures, distal esophageal spasm, hypercontractile esophagus, EGJ outflow disorders, hiatal hernias > 5 cm and lung transplant candidates/recipients were excluded. An experienced interpreter calculated the EGJ-CI and m-EGJ-CI for each study. Correlations were assessed using Spearman’s rank coefficient. The complexity of each parameter was estimated based on the calculation time required. Results Studies from 84 patients (58 women 69%; median age, 61 years IQR 49.5–69.5) were re-analyzed. A strong positive correlation between EGJ-CI and m-EGJ-CI was found ( ρ = 0.839 95%CI = 0.72–0.96, p < 0.05). The cumulative time for m-EGJ-CI calculations was significantly lower than that for EGJ-CI (15.7 vs. 60.3 min, p < 0.05). Conclusions The EGJ-CI calculation as an indicator of EGJ competence may be overly complex and time-consuming. The m-EGJ-CI saves time without compromising fidelity to EGJ-CI and can potentially be automated in future software versions. Graphical Abstract
Vittori et al. (Sat,) studied this question.