使用标准导丝对减重术后胃出口进行内镜测量的新方法的验证：一项观察者一致性研究。

Validation of a new method for the endoscopic measurement of post-bariatric gastric outlet using a standard guidewire: an observer agreement study.

作者信息

de Quadros Luiz Gustavo, Galvão Neto Manoel Dos Passos, Campos Josemberg Marins, Kaiser Junior Roberto Luiz, Grecco Eduardo, Flamini Junior Mario, de Santana Marcelo Falcao, Zotarelli Filho Idiberto Jose, Almeida Alexandre Adriano Augusto Tomas Vasconcelos

机构信息

Department of Endoscopy and Bariatric Surgery, Kaiser Clinic and Day Hospital, São José do Rio Preto, SP, 15015-110, Brazil.

Department of Digestive Surgery, School of Medicine of ABC, Santo Andre, SP, 09080-650, Brazil.

出版信息

BMC Res Notes. 2017 Jan 3;10(1):13. doi: 10.1186/s13104-016-2350-6.

DOI:10.1186/s13104-016-2350-6

PMID:28057045

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5217566/

Abstract

BACKGROUND AND AIMS

Between 10 and 20% of all patients undergoing bariatric surgery procedures regain weight secondary to a gastrojejunostomy enlargement. The aim of this study was to validate the interobserver agreement while measuring gastric outlet diameters using a new standard guidewire.

METHODS

We selected thirty-five videos of consecutive endoscopic procedures on patients undergoing esophagogastroduodenoscopy after a Roux-en-Y gastric bypass procedure. All videos were evaluated by four raters: two expert endoscopists and two trainees. We excluded videos having a slipped Fobi ring or a strictured gastric outlet. Anastomosis diameter was measured using a novel device with standardized markings on a guidewire (Hydra jagwire, Boston Scientific, Natick. MA) as well as the current gold standard defined as a calibrated endoscopic measuring instrument (Olympus America, Center Valley, PA).

RESULTS

We obtained 272 measurements of the gastric outlet. Overall agreement measured through intra-class correlation coefficients for the gold standard was 0.84 (p < 0.01) and 0.83 (p < 0.01) for the new guidewire. Agreement among experts was 0.699 (p < 0.01), while among trainees it was 0.822 (p < 0.01).

CONCLUSION

The new guidewire demonstrated a high degree of observer reliability, also presenting similar results between expert endoscopists and trainees.

摘要

背景与目的

在所有接受减肥手术的患者中，10%至20%会因胃空肠吻合口扩大而体重反弹。本研究的目的是在使用一种新型标准导丝测量胃出口直径时，验证观察者间的一致性。

方法

我们选择了35段连续的内镜检查视频，这些视频来自接受Roux-en-Y胃旁路手术后进行食管胃十二指肠镜检查的患者。所有视频由四名评估者进行评估：两名专家内镜医师和两名实习生。我们排除了有滑脱的Fobi环或胃出口狭窄的视频。使用一种在导丝上带有标准化标记的新型设备（Hydra jagwire，波士顿科学公司，马萨诸塞州纳蒂克）以及当前定义为校准内镜测量仪器的金标准（奥林巴斯美国公司，宾夕法尼亚州中心谷）来测量吻合口直径。