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首页> 外文期刊>Surgical Endoscopy >A prospective analysis of 3525 esophagogastroduodenoscopies performed by surgeons.
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A prospective analysis of 3525 esophagogastroduodenoscopies performed by surgeons.

机译：外科医生对3525例食管胃十二指肠镜检查进行前瞻性分析。

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Background: This study was undertaken to evaluate the safety and efficacy of surgeons performing esophagogastroduodenoscopy (EGD) and to use these results to assess existing credentialing guidelines for surgeons. Methods: A prospective outcomes study was designed to accept input from members of SAGES. End points were the time taken and rate of success in reaching the duodenum, the frequency of arriving at a diagnosis, and complications of EGD as related to operator experience. Results: Information from a total of 3,525 EGDs was prospectively entered into a database between December 2001 and December 2002. Common indications were abdominal painausea/vomiting (34.8%), gastroesophageal reflux disease (24.9%) and dysphagia (17.4%). The findings were inflammation in 1,895 (53.8%), hiatus hernia in 1,010 (28.7%), nonbleeding ulcer in 462 (13.1%), bleeding ulcer in 59 (1.7%), stricture in 344 (9.8%), and polyp/tumor in 206 (5.8%). Biopsies were obtained in 2080 (59.0%). Concomittant procedures performed were dilation in 253 (7.2%), removal of a foreign body (FB) or removal/insertion of a percutaneous endoscopic gastrostomy tube (PEG) in 190 (5.4%), and polypectomy in 59 (1.7%). The EGD was completed to the duodenum in 3282 patients (93.1%) with a mean procedure time of 9.2 min (range 1-60 min). Examination of the duodenum was not attempted in 231 patients for reasons such as previous gastric surgery ( n = 119), obstruction ( n = 58) or because the EGD was done for FB/PEG removal or PEG placement ( n = 36). Attempted EGD could not be completed in 12 patients (0.3%). The most common complication was hypoxia ( n = 57, 1.6%), which was treated with supplemental oxygen and observation. New bleeding occurred in eight patients and the procedure failed to control bleeding in three others. No complications occurred in 3447 patients (97.8%). Completion rates and major complications were not correlated to experience, but there was a significant association between experience and the time required for completion of the procedure ( p < 0.0001). Conclusions: This study shows that surgeons can perform EGD with a high degree of success and low morbidity. On the basis of this large prospective study, no minimum number of cases could be proposed for credentialing surgeons to safely perform either diagnostic or therapeutic esophagogastroduodenoscopy.
机译：背景：这项研究旨在评估进行食管胃十二指肠镜检查（EGD）的外科医生的安全性和有效性，并使用这些结果来评估现有的外科医生认证准则。方法：前瞻性结果研究旨在接受SAGES成员的意见。终点是到达十二指肠的时间和成功率，诊断的频率以及与操作员经验有关的EGD并发症。结果：前瞻性地将2001年12月至2002年12月之间总共3,525个EGD的信息输入数据库。常见的适应症是腹痛/恶心/呕吐（34.8％），胃食管反流病（24.9％）和吞咽困难（17.4％）。这些发现包括炎症1,895（53.8％），裂口疝1,010（28.7％），不出血溃疡462（13.1％），溃疡出血59（1.7％），狭窄344（9.8％）和息肉/肿瘤在206（5.8％）。 2080年获得了活检（59.0％）。进行的伴随手术包括：扩张术（253）（7.2％），异物切除术（FB）或经皮内镜下胃造瘘管（PEG）的拆除/插入术（190％（5.4％））和息肉切除术（59％（1.7％））。 EGD已完成3282例患者的十二指肠手术（93.1％），平均手术时间为9.2分钟（范围1-60分钟）。由于先前的胃外科手术（n = 119），阻塞（n = 58）或因为EGD是为了去除FB / PEG或PEG放置（n = 36）而进行的，未对231名患者进行十二指肠检查。尝试的EGD无法在12例患者中完成（0.3％）。最常见的并发症是缺氧（n = 57，1.6％），用补充氧气治疗并观察。 8名患者出现了新的出血，该手术未能控制其他3名患者的出血。 3447例患者中无并发症发生（97.8％）。完成率和主要并发症与经验无关，但是经验与完成手术所需时间之间存在显着关联（p <0.0001）。结论：这项研究表明，外科医生可以进行EGD，具有很高的成功率和较低的发病率。在这项大规模的前瞻性研究的基础上，没有提议最少数量的病例来认证外科医生以安全地进行诊断性或治疗性食管胃十二指肠镜检查。

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