Sivananthan Arun, Kerry Georgina, Darzi Ara, Patel Kinesh, Patel Nisha
Department of Surgery and Cancer, Imperial College London, London W2 1NY, United Kingdom.
Liver Intensive Care Unit, King's College Hospital NHS Foundation Trust, London SE5 9RS, United Kingdom.
World J Gastrointest Endosc. 2023 Mar 16;15(3):146-152. doi: 10.4253/wjge.v15.i3.146.
Oesophagogastroduodenoscopy is the gold standard investigation for the upper gastrointestinal (UGI) tract. Orientation during endoscopy is challenging and United Kingdom training focusses on technical competence and procedural safety. The reported location of UGI pathologies is crucial to post-endoscopic planning.
To evaluate endoscopists' ability to spatially orientate themselves within the UGI tract.
A cross sectional descriptive study elicited, using an anonymised survey, the ability of endoscopists to orientate themselves within the UGI tract. The primary outcome was percentage of correct answers from all surveyed; secondary outcomes were percentage of correct answers from experienced novice endoscopists. Pearson's test was applied to compare groups.
Of 188 respondents, 86 were experienced endoscopists having completed over 1000 endoscopies. 44.4% of respondents correctly identified the anterior stomach and 47.3% correctly identified the posterior of the second part of the duodenum (D2). Experienced endoscopists were significantly more likely than novice to identify the anterior stomach correctly [61.6% 31.3%, (1, = 188) = 11.10, = 0.001]. There was no significant difference between the two groups in identifying the posterior of D2.
The majority of endoscopists surveyed were unable to identify key landmarks within the UGI tract. Endoscopic orientation appears to improve with experience yet there are some areas still not well recognised. This has potential considerable impact on post-endoscopic management of patients with posterior duodenal ulcers being more likely to perforate and associated with a higher rebleeding risk. We suggest the development of a consensus statement on endoscopic description.
食管胃十二指肠镜检查是上消化道（UGI）疾病的金标准检查方法。内镜检查过程中的定位具有挑战性，英国的培训侧重于技术能力和操作安全性。UGI病变的报告位置对于内镜检查后的规划至关重要。
评估内镜医师在UGI内进行空间定位的能力。
一项横断面描述性研究通过匿名调查得出内镜医师在UGI内进行自我定位的能力。主要结果是所有被调查者的正确答案百分比；次要结果是经验丰富和新手内镜医师的正确答案百分比。应用Pearson卡方检验比较各组。
188名受访者中，86名是完成了超过1000例内镜检查的经验丰富的内镜医师。44.4%的受访者正确识别了胃前壁，47.3%的受访者正确识别了十二指肠第二部（D2）后壁。经验丰富的内镜医师比新手更有可能正确识别胃前壁[61.6%对31.3%，χ²（1，n = 188）= 11.10，P = 0.001]。两组在识别D2后壁方面没有显著差异。
大多数接受调查的内镜医师无法识别UGI内的关键标志。内镜定位能力似乎随着经验的增加而提高，但仍有一些区域尚未得到很好的识别。这可能对十二指肠后壁溃疡患者的内镜检查后管理产生相当大的影响，因为这些溃疡更容易穿孔且再出血风险更高。我们建议制定一份关于内镜描述的共识声明。
