Department of Gastrointestinal Endoscopy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15. Col. Sección XVI. Del. Tlalpan, C.P. 14000, Mexico City, Mexico.
Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
Surg Endosc. 2022 Jan;36(1):361-366. doi: 10.1007/s00464-021-08290-8. Epub 2021 Jan 25.
During the COVID-19 pandemic, several questions have arisen about which endoscopic procedures (EPs) must be performed and which ones can be postponed. The aim of this study was to conduct a nationwide survey regarding the appropriate timing of EPs during the COVID-19 pandemic.
This prospective study was performed through a nationwide electronic survey. The survey consisted of 15 questions divided into three sections. The first evaluated the agreement for EPs classified as "time sensitive" and "not time sensitive". Two other sections assessed "high-priority" and "low-priority" scenarios. Agreement was considered when > 75% of respondents answered a question in the same direction.
The response rate was 27.2% (214/784). Among the respondents, agreement for the need to perform EP in < 72 h was only reached for variceal bleeding (93.4%). Dysphagia with alarm symptoms was the scenario in which the highest percentage of physicians (95.9%) agreed that an EP needed to be performed within a month. Less than 30% of endoscopists would perform an EP within the first 72 h for patients with mild cholangitis, non-variceal upper gastrointestinal bleeding without hemodynamic instability, or severe anaemia without overt bleeding. In time-sensitive clinical scenarios suggestive of benign disease, none of the scenarios reached agreement in any sense. Among the time-sensitive clinical scenarios suggestive of malignancy, > 90% of the surveyed respondents considered that EP could not be postponed for > 8 weeks.
There was no consensus among endoscopists about the timing of EPs in patients with pathologies considered time sensitive or in those with high-priority pathologies. Agreement was only reached in five (17%) of the evaluated clinical scenarios.
在 COVID-19 大流行期间，人们对哪些内镜检查（EPs）必须进行，哪些可以推迟产生了疑问。本研究旨在针对 COVID-19 大流行期间进行 EP 的适当时机进行全国性调查。
本前瞻性研究通过全国范围内的电子调查进行。该调查由 15 个问题组成，分为三个部分。第一部分评估了对分类为“时间敏感”和“非时间敏感”的 EP 的一致性。另外两个部分评估了“高优先级”和“低优先级”的情况。当>75%的受访者对同一方向的问题给出相同答案时，则认为存在一致性。
回复率为 27.2%（214/784）。在受访者中，只有在<72 小时内进行 EP 的必要性在静脉曲张出血方面达成了一致（93.4%）。有报警症状的吞咽困难是最高比例的医生（95.9%）认为需要在一个月内进行 EP 的情况。不到 30%的内镜医生会在最初的 72 小时内为患有轻度胆管炎、无血流动力学不稳定的非静脉曲张性上消化道出血或无明显出血的严重贫血的患者进行 EP。在提示良性疾病的时间敏感临床情况下，没有任何情况在任何方面达成一致。在提示恶性疾病的时间敏感临床情况下，>90%的受访者认为 EP 不能推迟>8 周。
在考虑时间敏感或高优先级的病理情况下，内镜医生对 EP 的时机没有达成共识。在评估的 15 个临床情况下，只有 5 个（17%）达成了一致。
