ASGE Esophagology: Tailoring Management from Testing to Treatment (Live and Virtual) | July 2022-S. Parasa_Performing a High Quality Upper Endoscopic Examination

S. Parasa_Performing a High Quality Upper Endoscopic Examination

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This document outlines the importance of performing a high-quality upper endoscopic exam. The author emphasizes that a high-quality exam is necessary for diagnosis, treatment, and surveillance purposes. The components of a good exam include HD-WLE endoscopy, clarity of the mucosa (checking for bubbles, food, blood, and liquid), adequate inspection time for specific areas such as Barrett's esophagus and the stomach, and the use of advanced imaging techniques.<br /><br />Visualization is an essential aspect of a high-quality exam. Advanced imaging technologies can help identify mucosal patterns and vascular patterns, which can indicate normal or abnormal findings. Techniques like using mucolytic agents, suctioning food or clots, and careful high-powered suction can improve visualization by minimizing obstructions. Washing the area being examined is also important.<br /><br />The document highlights the importance of spending sufficient time during the examination. Longer inspection time in Barrett's esophagus is associated with detecting high-grade dysplasia and esophageal adenocarcinoma. In gastric inspection, spending at least 7 minutes increases the proportion of neoplasms detected.<br /><br />Biopsy protocols for common upper gastrointestinal endoscopy indications are mentioned for diagnosis purposes. Implementation of high-quality endoscopy involves focusing on a few measurable metrics, dedicated staff for measuring quality, and the use of AI/computer vision and quality metrics in endoscopy.<br /><br />In conclusion, performing a high-quality upper endoscopic exam is crucial for accurate diagnosis, effective treatment, and surveillance. Adequate visualization, including the use of advanced imaging techniques, proper inspection time, and biopsy protocols, is essential. Implementing and auditing the practice to ensure quality endoscopy is also important.

Keywords

upper endoscopic exam

high-quality exam

diagnosis

treatment

surveillance

visualization

inspection time

advanced imaging techniques

biopsy protocols

quality endoscopy