A prospective analysis of 3525 esophagogastroduodenoscopies performed by surgeons

Reed, William P.; Kilkenny, John; Dias, C. E.; Wexner, Steven D.

doi:10.1007/s00464-003-8913-3

Cited by 31 publications

(17 citation statements)

References 46 publications

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“…The Association for Gastrointestinal Endoscopy (ASGE) does not specifically mention IF [26], but states that complete examinations should be achieved in >98% of gastroscopies. Based on our data, and that from Reed et al [7], we propose that an IF rate of <1% is a realistic and auditable quality metric in gastroscopy.…”

Section: Predictors Of Abnormal Radiology In Patients With Ifsupporting

confidence: 64%

“…The limited data relating to gastroscopy failure have largely approached the issue from the angle of patient intolerance and discomfort. Data from Reed et al [7], involving 3,525 gastroscopies performed by surgeons, demonstrated a 0.3% rate of incomplete examinations to the stomach, but does not report rates of IF. Qualitative research investigating the psychological aspects of 'failure to tolerate' endoscopy have identified patient apprehensions arising from feelings of vulnerability, embarrassment, fear of physical discomfort, as well as anxiety over the outcome of the investigation [8,9].…”

Section: Discussionmentioning

confidence: 98%

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Intubation Failure During Gastroscopy: Incidence, Predictors and Follow-Up Findings

Siau

Fisher

et al. 2017

JGLD

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Background: Intubation failure (IF) occurs when an endoscopist is unable to progress via the oropharynx into the upper oesophagus. Aim: To assess incidence and aetiology of IF and predictors of structural pharyngeal abnormalities in patients with IF.Methods: All gastroscopies (n=26,130) performed in our centre, between August 2010 and August 2016 were retrospectively reviewed. Barium radiology and repeat gastroscopy findings were evaluated for structural causes of IF. Patients were categorised into ‘failure to tolerate’ and ‘failure to progress’ based on endoscopy reports.Results: The incidence of IF was 0.95%. Rates of IF varied with endoscopist specialty (p=0.021), but not with patient age, sex or sedation dose. Among cases of IF, structural pharyngeal abnormalities were detected on barium radiology in 28.9%, consisting of cricopharyngeal hypertrophy and/or Zenker’s diverticulum in 73.2%. ‘Failure to progress’ predicted pharyngeal pathology in 55.6%. Predictors of structural causes on barium radiology following IF included: age ≥65 (OR 4.0, 95% CI: 1.8-8.9, p<0.001); indication of dysphagia (OR 5.5, 95% CI: 2.5-11.8, p<0.001), and failure of endoscopic progression (OR 5.2, 95% CI: 2.3-12.0, p<0.001).Conclusion: Patients with IF should be investigated owing to the high risk of underlying pathology, particularly if associated with age ≥65, dysphagia, and failure of endoscopic progression. We propose that IF rates of <1% could be used as a quality indicator in gastroscopy. .Abbreviations: ASGE: Association for Gastrointestinal Endoscopy; CI: Confidence interval; CP: Cricopharyngeus; CPH: Cricopharyngeal hypertrophy; FESD: Flexible endoscopic septum division; GRS: Global rating scale; IF: Intubation failure; JAG: Joint Advisory Group for gastrointestinal endoscopy; NME: Non-medical endoscopist; OR: Odds ratio; SI: Successful intubation; ZD: Zenker’s diverticulum.

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Section: Predictors Of Abnormal Radiology In Patients With Ifsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 98%

Intubation Failure During Gastroscopy: Incidence, Predictors and Follow-Up Findings

Siau

Fisher

et al. 2017

JGLD

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“…In the surgical literature, Wexner et al [14] found that only 50 colonoscopies were necessary to achieve a 90% completion rate. Other surgical studies have failed to demonstrate a strong correlation between the number of cases managed and rates of completion or complications [15]. An objective instrument to measure clinical performance such as GAGES could be a more accurate way to measure competence.…”

Section: Discussionmentioning

confidence: 99%

Global Assessment of Gastrointestinal Endoscopic Skills (GAGES): a valid measurement tool for technical skills in flexible endoscopy

et al. 2010

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“…It has been demonstrated in large multicenter series that there is no difference in the procedure success rates between these groups (8,9). However, all these studies have focused on the technical success and complications of endoscopic procedures, and differences in the management of patients following detection of the underlying disorder has not been investigated.…”

Section: Discussionmentioning

confidence: 99%

The effect of the endoscopist on the wait-time for colorectal cancer surgery

Karıp

İşcan

Ağca

et al. 2014

UCD

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Objective: The effect of the specialty of physicians who perform endoscopy on preoperative wait-time of colorectal cancer patients was evaluated. Material and Methods:Data from 86 patients who have been operated with a diagnosis of colorectal cancer from January 2011-February 2013 regarding age, sex, tumor location, colonoscopy date, surgery date, the expertise and institution of the endoscopist were retrospectively examined. The time between colonoscopy and surgery was accepted as the pre-operative wait time (PWT). Results:Out of 86 patients, 24 (27.9%) colonoscopies were performed by general surgeons (GS), and 62 (72.1%) by gastroenterologists (GE). When patients who underwent colonoscopy in other centers were extracted, the PWT for our center was 20.4±10.8 days. When grouped according to specialties, the PWT of patients who had their colonoscopy performed by GS was significantly shorter than patients who underwent colonoscopy by GE at the same center (p<0.05). Patient's age, sex and location of the tumor had no effect on PWT (p>0.05). Conclusion:The preparation time for surgery in colorectal cancer patients is influenced by the specialty of the physician performing the procedure. In order to standardize this period, a common flow diagram after endoscopy should be established for patients with suspected malignancy.

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A prospective analysis of 3525 esophagogastroduodenoscopies performed by surgeons

Cited by 31 publications

References 46 publications

Intubation Failure During Gastroscopy: Incidence, Predictors and Follow-Up Findings

Intubation Failure During Gastroscopy: Incidence, Predictors and Follow-Up Findings

Global Assessment of Gastrointestinal Endoscopic Skills (GAGES): a valid measurement tool for technical skills in flexible endoscopy

The effect of the endoscopist on the wait-time for colorectal cancer surgery

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