Association between sedation and small neoplasm detection during diagnostic esophagogastroduodenoscopy: a propensity score-matched retrospective study

Wu, Hao; Xin, Lei; Lin, Jin‐Huan; Wang, Qinghua; Li, Bo; Jin, Zhendong; Hu, Liang‐Hao; Zou, Wenbin; Qin, Ke; Yang, Ting; Li, Zhao‐Shen; Liao, Zhuan

doi:10.1080/00365521.2021.2023212

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Another multicenter study found that sedation improved the detection rate of early cancer and precancerous lesions in EGD screening ( 24 ). Hao Wu also found a higher detection rate of small upper gastrointestinal neoplasms in patients undergoing sedation-assisted EGD screening ( 25 ). These findings contradict our study.…”

Section: Discussionmentioning

confidence: 99%

Effect of anesthesia assistance on the detection rate of precancerous lesions and early esophageal squamous cell cancer in esophagogastroduodenoscopy screening: A retrospective study based on propensity score matching

Liang

Xu²,

Zhang³

et al. 2023

Front. Med.

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BackgroundEsophagogastroduodenoscopy (EGD) screening is vital for the early diagnosis of esophageal squamous cell cancer (ESCC). However, improvement in the detection rate of precancerous lesions and early ESCC with anesthesia assistance (AA) has not yet been investigated. This retrospective study aimed to evaluate the effect of AA on the detection rate of precancerous lesions and early ESCC in patients undergoing EGD screening and identify risk factors affecting the detection rate.MethodsWe reviewed patients’ electronic medical records who underwent EGD screening between May 2019 and August 2020. Patients were divided into two groups based on whether they received AA: those in Group A underwent EGD screening with AA, and patients in Group O underwent EGD screening without AA. Propensity score matching (PSM) was used to account for differences in baseline characteristics. Detection rates of precancerous lesions and early ESCC were compared between the two groups following PSM. Binary logistic regression was used to identify risk factors affecting the detection rate.ResultsThe final analysis included 21,835 patients (Group A = 13,319, Group O = 8,516) from 28,985 patients who underwent EGD screening during the study period. Following PSM, 6009 patients remained in each group for analysis. There was no significant difference in the detection rate of precancerous lesions and early ESCC between Groups A and O (1.1% vs. 0.8%, p > 0.05). Binary logistic regression showed that age (50–59 years, 60–69 years and 70–79 years), higher endoscopist seniority, high-definition (HD) endoscopy, narrow-band imaging (NBI), and number of endoscopic images were all independent risk factors that affected the detection rate of precancerous lesions and early ESCC.ConclusionThere was no statistically significant difference in the detection rate of precancerous lesions and early ESCC between patients who underwent EGD screening with and without AA. All independent risk factors that affected the detection rate of precancerous lesions and early ESCC included the following: age (50–59 years, 60–69 years and 70–79 years), higher endoscopist seniority, HD endoscopy, NBI, and number of endoscopic images. Endoscopists should consider all these factors as much as possible when performing EGD screening.

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Section: Discussionmentioning

confidence: 99%

Effect of anesthesia assistance on the detection rate of precancerous lesions and early esophageal squamous cell cancer in esophagogastroduodenoscopy screening: A retrospective study based on propensity score matching

Liang

Xu²,

Zhang³

et al. 2023

Front. Med.

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“…It is also recommended to use ECG monitoring for patients with cardiopulmonary disease, elderly patients, and during longer procedures. [18] Children are at a higher risk of encountering adverse consequences when undergoing procedural sedation for esophagogastroduodenoscopy (OGD). Therefore, it is imperative to prioritize the safety of pediatric patients during the performance of OGD.…”

Section: Anesthesiamentioning

confidence: 99%

Endoscopy without Sedation less Time in the Recovery Unit Post-Procedure

2023

J Surg

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Background In this study, we compared the length of time in the recovery room following endoscopic procedures with and without sedation and looked for any differences in pain scores that were statistically significant. MethodsRetrospective study, which was taken from the patient's records in the recovery unit, with a sample of 200 patients.Result Regarding the sociodemographic data the mean age was 60.5 years old generally, with 108 males (54%), and 92 females (46%. Regarding the type of sedation, 50 patients had OGD with no sedation (25%), and 50 had it with sedation (25%). 50 patients had colonoscopy with only fentanyl (25%), and 50 had it with both fentanyl and midazolam (25%). Regarding the dose range of fentanyl,100 patients had it, 97 between 25-50 mcg and 3 patients had more than 50 mcg, for the dose of midazolam, 100 patients had it, 95 patients had between 1.5-3.0 mg, 5 had between 4-5 mg. The LOS (min) 99 patients had more than 120 minutes (49.5%), 58 between 61-120 (29%), and 43 between 9-60 minutes (21.5%) in the recovery unit. ConclusionThis study has concluded that most of the patients who have had endoscopy with sedation had a prolonged time in recovery compared to patients who didn't have sedation and had a lower time in recovery. For colonoscopy, most of the patients had a longer time when using both midazolam and fentanyl compared to those who had only fentanyl, which indicates that using midazolam increases the time in recovery. The higher the dose of sedation the more time in the recovery post-endoscopy. There was no significant difference in pain score in colonoscopy with sedation or without.

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Association between anesthesia assistance and precancerous lesions and early cancer detection during diagnostic esophagogastroduodenoscopy: a propensity score-matched retrospective study

Liu,

2024

Front. Med.

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BackgroundEsophagogastroduodenoscopy (EGD) is a fundamental procedure for early detection of upper gastrointestinal (UGI) cancer. However, limited research has been conducted on the impact of sedation during EGD on the identification of precancerous lesions and early cancer (EC). This retrospective study aims to evaluate whether sedation during EGD can improve the detection rates of precancerous lesions and EC.MethodsIn this propensity score-matched retrospective study, we examined medical records from outpatients who underwent diagnostic EGD at a large tertiary center between January 2023 and December 2023. Data on endoscopic findings and histology biopsies were obtained from an endoscopy quality-control system. The primary objective was to compare the rates of detecting precancerous lesions and EC in patients who received sedation during EGD vs. those who did not receive sedation. Additionally, we aimed to identify factors influencing these detection rates using binary logistic regression analysis.ResultsFollowing propensity score matching, a total of 17,862 patients who underwent diagnostic EGD with or without propofol sedation were identified. The group that received sedation exhibited a higher detection rate of precancerous lesions and EC in comparison to the non-sedated group (1.04 vs. 0.75%; p = 0.039). Additionally, within the sedated group, there was an increased likelihood of identifying precancerous lesions and EC specifically at the gastric antrum (0.60 vs. 0.32%, p = 0.006). Binary logistic regression analysis demonstrated that independent risk factors influencing the detection rates included age, gender, observation time, and number of biopsies conducted during the procedure.ConclusionAnesthesia assistance during EGD screening proved advantageous in detecting EC as well as precancerous lesions. It is crucial for endoscopists to consider these factors when performing EGD screening procedures.

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Association between sedation and small neoplasm detection during diagnostic esophagogastroduodenoscopy: a propensity score-matched retrospective study

Cited by 3 publications

References 30 publications

Effect of anesthesia assistance on the detection rate of precancerous lesions and early esophageal squamous cell cancer in esophagogastroduodenoscopy screening: A retrospective study based on propensity score matching

Effect of anesthesia assistance on the detection rate of precancerous lesions and early esophageal squamous cell cancer in esophagogastroduodenoscopy screening: A retrospective study based on propensity score matching

Endoscopy without Sedation less Time in the Recovery Unit Post-Procedure

Association between anesthesia assistance and precancerous lesions and early cancer detection during diagnostic esophagogastroduodenoscopy: a propensity score-matched retrospective study

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