One day of upper gastrointestinal endoscopy in a southern European country
Introduction: Upper gastrointestinal (UGI) endoscopic outcomes are seldom described. Objectives: To assess UGI endoscopy performance in all Portugals National Health Service hospitals and assess the prevalence of premalignant gastric lesions. Methods: One randomly assigned day, cross-sectional study of UGI endoscopies. Results: 28% of the 43 hospitals invited actually participated in the study, reporting a total of 123 UGI endoscopies. Exams were conducted on an outpatient basis in 84% of cases and 78% required no sedation. The commonest indications were presence or suspicion of GI bleeding (20%), abdominal pain or dyspepsia (18%) or reflux (12%). Histological diagnosis of atrophy was found in 19% of cases (95% CI 8-30%), extensive atrophy or intestinal metaplasia in corpus in 15% (5-25%) and positivity for Helicobacter pylori in 38% (23-53%). When comparing first-time vs. repeat UGI endoscopies, no differences were found in atrophy (22% vs. 14%, p = 0.49) and H. pylori (44% vs. 30%, p = 0.36) nor did age < vs.≥50 years was relevant (11% vs. 21%, p = 0.51 and 63% vs. 31%, p = 0.10, respectively). Conclusions: Most UGI endoscopies carried out in Portugal are safely performed on an outpatient basis without anaesthesia and 15% of patients have extensive atrophy or intestinal metaplasia in the corpus that should be scheduled for endoscopic surveillance according to recent guidelines. Although the participation rate was low, this study is an insight for further decision analysis studies to evaluate UGI endoscopy as a surveillance option for these asymptomatic at-risk patients.
| Main Authors: | , |
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| Format: | Digital revista |
| Language: | English |
| Published: |
Sociedade Portuguesa de Gastrenterologia
2014
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| Online Access: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-81782014000300005 |
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| Summary: | Introduction: Upper gastrointestinal (UGI) endoscopic outcomes are seldom described. Objectives: To assess UGI endoscopy performance in all Portugals National Health Service hospitals and assess the prevalence of premalignant gastric lesions. Methods: One randomly assigned day, cross-sectional study of UGI endoscopies. Results: 28% of the 43 hospitals invited actually participated in the study, reporting a total of 123 UGI endoscopies. Exams were conducted on an outpatient basis in 84% of cases and 78% required no sedation. The commonest indications were presence or suspicion of GI bleeding (20%), abdominal pain or dyspepsia (18%) or reflux (12%). Histological diagnosis of atrophy was found in 19% of cases (95% CI 8-30%), extensive atrophy or intestinal metaplasia in corpus in 15% (5-25%) and positivity for Helicobacter pylori in 38% (23-53%). When comparing first-time vs. repeat UGI endoscopies, no differences were found in atrophy (22% vs. 14%, p = 0.49) and H. pylori (44% vs. 30%, p = 0.36) nor did age < vs.≥50 years was relevant (11% vs. 21%, p = 0.51 and 63% vs. 31%, p = 0.10, respectively). Conclusions: Most UGI endoscopies carried out in Portugal are safely performed on an outpatient basis without anaesthesia and 15% of patients have extensive atrophy or intestinal metaplasia in the corpus that should be scheduled for endoscopic surveillance according to recent guidelines. Although the participation rate was low, this study is an insight for further decision analysis studies to evaluate UGI endoscopy as a surveillance option for these asymptomatic at-risk patients. |
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