Yuan Y Stevenson, MD, Nan Walsh, CRNP, Robert D Fanelli, MD, MHA, FACS, FASGE. Guthrie Robert Packer Hospital
Introduction: Side-viewing endoscopes used for endoscopic ultrasound (EUS) provide almost no view of the esophagus during insertion. Esophagogastroduodenoscopy (EGD) routinely is performed immediately prior to EUS to rule out obstructive lesions, stenoses, or to identify the location of mucosal and submucosal lesions that are the target of EUS. Few studies have looked at the impact the findings on routine EGD have on clinical management. This study reviews the significance of findings on routine EGD completed prior to EUS.
Methods: A retrospective chart review was conducted at a 254-bed tertiary care teaching hospital. A total of 379 patients underwent 395 EGD/EUS during 13 months from June 2017 through June 2018. EGD findings were categorized into four significance categories: 1) normal/no reportable findings; 2) minimally significant findings/no intervention required; 3) significant findings/minor intervention required; 4) significant findings/surgery or other major intervention required. The distribution of significance categories for EGD findings was calculated. Categorical variables were analyzed using a chi-square test of association and continuous variables were analyzed using a one-way ANOVA. Four patients did not have EGD reports in the electronic health record and therefore were excluded.
Results: The majority of EGD findings were category 2 (50.38%), followed by category 1 (39.24%), category 3 (5.32%), and then category 4 (5.06%). There was no significant difference in mean age of patients across significance levels.
Conclusions: Routine EGD prior to EUS improves safety by ruling out obstructing lesions and stenoses, and localizes mucosal/submucosal lesions for study. Abnormal EGD findings are identified in 60.76% of patients, but intervention is required in only 10.92%.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93778
Program Number: P440
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster