Geraci G, Pisello F, Modica G, Li Volsi F, Arnone E, Sciumè C
Università degli Studi di Palermo, Sezione di Chirurgia Generale ad Indirizzo Toracico.
G Chir. 2009 Nov-Dec;30(11-12):502-6.
Although upper gastrointestinal (GI) endoscopy is reasonably safe, it is not perfectly so. The complication rate is about 0.1% for EGDS. Aim of this study is to schedule and evaluate all possible complications, starting from personal experience in Operative Unit of Surgical Endoscopy.
We evaluated all EGDS performed at the Operative Unit of Surgical Endoscopy of Policlinico in Palermo between January 2000 and January 2008. A single staff of endoscopists performed diagnostic and therapeutic exam. All complications were tabulated and scheduled to identify possible risk factors or indicators procedure- or patient-related.
5.258 patients (43.6 %) experienced temporary and self-limiting hypoxia (SaO2 < 85%); we report totally 18 complications (0.15%), according to literature data: 2 hypopharinx perforations (0.016%), 2 middle esophagus perforation (either with death of patients = 0.016%), 3 post-biopsy hematomas of the gastric wall (0.02%) and 2 duodenal wall (0.016%) 6 (0.04%) post-polypectomy bleeding, 1 abscess post-percutaneous endoscopic gastrostomy (PEG) (0.008%) and 1 accidentally PEG remove (0.008%).
EGDS-related complications may occur and cannot be prevented completely even in expert hands however, early recognition and proper management will lead to better outcome. Because of the complexity of endoscopic procedures has increased, endoscopists need to be aware of all possible procedure-related complications and should use strategies to minimize it.
Endoscopic complications will inevitably occur if an endoscopist does many procedures. The knowledge of potential complications and their expected frequency can lead to improved risk-benefit analysis by physicians and patients as well as true informed consent by patients. Early recognition of complications and prompt intervention may minimize patient morbidity.
尽管上消化道（GI）内镜检查相当安全，但并非绝对如此。食管胃镜检查（EGDS）的并发症发生率约为0.1%。本研究的目的是根据外科内镜手术科室的个人经验，梳理并评估所有可能的并发症。
我们评估了2000年1月至2008年1月在巴勒莫综合医院外科内镜手术科室进行的所有食管胃镜检查。由单一内镜医师团队进行诊断和治疗检查。将所有并发症列表并梳理，以确定可能的风险因素或与手术或患者相关的指标。
5258例患者（43.6%）出现短暂的、自限性的低氧血症（动脉血氧饱和度<85%）；根据文献数据，我们共报告了18例并发症（0.15%）：2例下咽穿孔（0.016%），2例食管中段穿孔（其中1例患者死亡=0.016%），3例胃壁活检后血肿（0.02%）和2例十二指肠壁血肿（0.016%），6例（0.04%）息肉切除术后出血，1例经皮内镜下胃造口术（PEG）后脓肿（0.008%）和1例PEG意外移除（0.008%）。
即使是经验丰富的医生，EGDS相关并发症仍可能发生且无法完全预防，然而，早期识别和妥善处理将带来更好的结果。由于内镜手术的复杂性增加，内镜医师需要了解所有可能的与手术相关的并发症，并应采取策略将其降至最低。
如果内镜医师进行大量手术，内镜并发症将不可避免地发生。了解潜在并发症及其预期发生率可以使医生和患者更好地进行风险效益分析，并使患者真正知情同意。早期识别并发症并及时干预可能会将患者的发病率降至最低。
