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

S. Parasa_Performing a High Quality Upper Endoscopic Examination

Pdf Summary

This document discusses the importance of performing a high quality upper endoscopic exam and outlines the components necessary for achieving this. The primary reasons for performing a quality endoscopy are for diagnosis, treatment, and surveillance purposes. The components of a good exam include high-definition white light endoscopy, clear visualization of the mucosa without bubbles, food, blood, or liquid, sufficient inspection time for areas like Barrett's esophagus and the stomach, and the use of advanced imaging techniques. Advanced imaging technologies can help identify landmarks, mucosal patterns, and vascular patterns. Techniques for improving visualization include using mucolytic agents like simethicone and NAC, suctioning food or clots, and careful high-powered suction. It is also important to spend an appropriate amount of time inspecting areas like the esophagus (Barrett's Inspection Time) and the stomach (Gastric Inspection Time). Longer inspection times have been associated with increased detection of high-grade dysplasia and cancer. Biopsy protocols for common upper gastrointestinal endoscopy indications are also discussed. Implementation of quality endoscopy practices involves focusing on a few measurable metrics, dedicating staff to measure quality, and potentially using artificial intelligence and computer vision to assist with quality metrics. The document concludes with an invitation for questions.

Keywords

upper endoscopic exam

diagnosis

treatment

surveillance

high-definition white light endoscopy

advanced imaging techniques

Barrett's Inspection Time

Gastric Inspection Time

biopsy protocols

quality endoscopy practices