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Background <p>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.</p> Aims <p>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.</p> Methods <p>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 &gt; 5&#xa0;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.</p> Results <p>Studies from 84 patients (58 women [69%]; median age, 61&#xa0;years [IQR 49.5–69.5]) were re-analyzed. A strong positive correlation between EGJ-CI and m-EGJ-CI was found (<i>ρ</i> = 0.839 [95%CI = 0.72–0.96], <i>p</i> &lt; 0.05). The cumulative time for m-EGJ-CI calculations was significantly lower than that for EGJ-CI (15.7 vs. 60.3&#xa0;min, <i>p</i> &lt; 0.05).</p> Conclusions <p>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.</p> Graphical Abstract <p></p>

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Simplifying the esophagogastric junction contractile integral calculation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月17日

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  • Arianna Vittori,
  • Andrés R. Latorre-Rodríguez,
  • Sumeet K. Mittal

摘要

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