Ravindran Nikila C, Vasilevska-Ristovska Jovanka, Coburn Natalie G, Mahar Alyson, Zhang Yimeng, Gunraj Nadia, Sutradhar Rinku, Law Calvin H, Tinmouth Jill
Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
Surg Endosc. 2014 May;28(5):1660-7. doi: 10.1007/s00464-013-3367-8. Epub 2014 Jan 23.
There is a lack of existing literature regarding the quality of esophagogastroduodenoscopy (EGD) reporting for gastric cancer evaluation. This study aims to determine criteria for quality endoscopic evaluation of gastric cancer in North America by identifying important features of the EGD report for pre-operative evaluation of gastric cancer and assessing inclusion of these features in existing reports.
Semi-structured interviews were conducted with experienced endoscopists from community and academic hospitals affiliated with the University of Toronto to identify essential elements for an EGD report. Then, 225 EGD reports from 2005 to 2008 were evaluated by two trained reviewers for inclusion of recommended EGD report elements and global assessment of report quality and adequacy for surgical planning.
Essential elements recommended by interviewed endoscopists include tumor size, location, and distance from gastroesophageal junction (GEJ). Approximately 95 % of all reports documented the location of lesions, <5 % documented distance from the GEJ, and <15 % documented tumor size. Overall report quality was rated as excellent for 4-5 % of reports; 20-42 % of all reports were deemed to be adequate for surgical planning. All surgeons interviewed as part of the endoscopist panel indicated that they would repeat the EGD before consulting with patients regarding surgical planning.
For pre-operative evaluation of gastric cancer, tumor size, location, and distance from key anatomical landmarks were proposed as essential elements of a quality EGD report. Most of the reviewed reports did not document these elements. Report quality is perceived to be poor and may lead to repeat endoscopy. Developing a standardized EGD reporting format based on inclusion of individual parameters can improve the quality of gastric cancer management.
目前缺乏关于用于胃癌评估的食管胃十二指肠镜检查（EGD）报告质量的文献。本研究旨在通过确定用于胃癌术前评估的EGD报告的重要特征，并评估现有报告中这些特征的纳入情况，来确定北美地区胃癌高质量内镜评估的标准。
对多伦多大学附属社区医院和学术医院的经验丰富的内镜医师进行半结构化访谈，以确定EGD报告的基本要素。然后，由两名经过培训的评审人员对2005年至2008年的225份EGD报告进行评估，以确定是否包含推荐的EGD报告要素，以及对报告质量和手术规划充分性进行整体评估。
受访内镜医师推荐的基本要素包括肿瘤大小、位置以及距胃食管交界（GEJ）的距离。所有报告中约95%记录了病变位置，<5%记录了距GEJ的距离，<15%记录了肿瘤大小。整体报告质量评为优秀的报告占4 - 5%；所有报告中20 - 42%被认为足以用于手术规划。作为内镜医师小组一部分接受访谈的所有外科医生均表示，在与患者讨论手术规划之前，他们会重复进行EGD检查。
对于胃癌的术前评估，肿瘤大小、位置以及距关键解剖标志的距离被提议作为高质量EGD报告的基本要素。大多数审查报告未记录这些要素。报告质量被认为较差，可能导致重复进行内镜检查。基于纳入个体参数制定标准化的EGD报告格式可提高胃癌管理的质量。
