← Issue №14/ week of Oct 4, 2026/Esophagus/Reflux

Diagnostic Accuracy of High-Resolution Manometry for Assessing Fundoplication Integrity: Validation of the Padova Classification.

From GI Signals issue №14: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Esophagus/Reflux prospective cohort · n=373 · Oct 1, 2026 · Neurogastro Motil · IF 3.5

Diagnostic Accuracy of High-Resolution Manometry for Assessing Fundoplication Integrity: Validation of the Padova Classification.

Diagnosticesophageal motility
Clinical takeawayUse the Padova Classification with high-resolution manometry (HRM) to assess fundoplication integrity in patients with recurrent symptoms post-laparoscopic fundoplication (LF), particularly to identify post-fundoplication outflow obstruction (PFOO) using an IRP cutoff of 18.1 mmHg.
What it foundThe Padova Classification showed sensitivity/specificity 94.7%/97.1% for FELF, 88.8%/96.9% for INB, and 100%/97.4% for PFOO when validated against a composite reference standard (clinical, radiological, endoscopic, and pH-monitoring criteria), with postoperative IRP accurately discriminating PFOO (AUC 0.959-0.984; cutoff 18.1 mmHg).
ContextThis validates the Padova Classification as a reliable tool for postoperative LF assessment, addressing a diagnostic gap in distinguishing functioning from defective fundoplications in patients with recurrent symptoms post-LF.
No standard claimed for this paper

Every paper is compared to the standard governing its question. This one is not: either no standard in the corpus matches it, or the comparison did not hold up on review and was withdrawn rather than published unverified. Both are logged.

Vittori A … Salvador R · Neurogastroenterology and Motility · IF 3.5 · PubMed ↗Permalink
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