Khalaf Kareem, Pawlak Katarzyna M, Adler Douglas G, Alkandari Asma A, Barkun Alan N, Baron Todd H, Bechara Robert, Berzin Tyler M, Binda Cecilia, Cai Ming-Yan, Carrara Silvia, Chen Yen-I, de Moura Eduardo Guimarães Hourneaux, Forbes Nauzer, Fugazza Alessandro, Hassan Cesare, James Paul D, Kahaleh Michel, Martin Harry, Maselli Roberta, May Gary R, Mosko Jeffrey D, Oyeleke Ganiyat Kikelomo, Petersen Bret T, Repici Alessandro, Saxena Payal, Sethi Amrita, Sharaiha Reem Z, Spadaccini Marco, Tang Raymond Shing-Yan, Teshima Christopher W, Villarroel Mariano, van Hooft Jeanin E, Voermans Rogier P, von Renteln Daniel, Walsh Catharine M, Aberin Tricia, Banavage Dawn, Chen Jowell A, Clancy James, Drake Heather, Im Melanie, Low Chooi Peng, Myszko Alexandra, Navarro Krista, Redman Jessica, Reyes Wayne, Weinstein Faina, Gupta Sunil, Mokhtar Ahmed H, Na Caleb, Tham Daniel, Fujiyoshi Yusuke, He Tony, Malipatil Sharan B, Gholami Reza, Gimpaya Nikko, Kundra Arjun, Grover Samir C, Causada Calo Natalia S
Division of Gastroenterology, St Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Denver, USA.
Endosc Int Open. 2024 Nov 18;12(11):E1315-E1325. doi: 10.1055/a-2427-3893. eCollection 2024 Nov.
Use of fluoroscopy in gastrointestinal endoscopy is an essential aid in advanced endoscopic interventions. However, it also raises concerns about radiation exposure. This study aimed to develop consensus-based statements for safe and effective use of fluoroscopy in gastrointestinal endoscopy, prioritizing the safety and well-being of healthcare workers and patients. A modified Delphi approach was employed to achieve consensus over three rounds of surveys. Proposed statements were generated in Round 1. In the second round, panelists rated potential statements on a 5-point scale, with consensus defined as ≥80% agreement. Statements were subsequently prioritized in Round 3, using a 1 (lowest priority) to 10 (highest priority) scale. Forty-six experts participated, consisting of 34 therapeutic endoscopists and 12 endoscopy nurses from six continents, with an overall 45.6% female representation (n = 21). Forty-three item statements were generated in the first round. Of these, 31 statements achieved consensus after the second round. These statements were categorized into General Considerations (n = 6), Education (n = 10), Pregnancy (n = 4), Family Planning (n = 2), Patient Safety (n = 4), and Staff Safety (n = 5). In the third round, accepted statements received mean priority scores ranging from 7.28 to 9.36, with 87.2% of statements rated as very high priority (mean score ≥ 9). This study presents consensus-based statements for safe and effective use of fluoroscopy in gastrointestinal endoscopy, addressing the well-being of healthcare workers and patients. These consensus-based statements aim to mitigate risks associated with radiation exposure while maintaining benefits of fluoroscopy, ultimately promoting a culture of safety in healthcare settings.
在胃肠内镜检查中使用荧光透视是高级内镜干预的一项重要辅助手段。然而，它也引发了对辐射暴露的担忧。本研究旨在制定基于共识的关于在胃肠内镜检查中安全有效使用荧光透视的声明，将医护人员和患者的安全与福祉放在首位。采用了一种改良的德尔菲法，通过三轮调查达成共识。第一轮提出声明。在第二轮中，小组成员以5分制对潜在声明进行评分，共识定义为≥80%的同意率。随后在第三轮中，使用1（最低优先级）至10（最高优先级）的量表对声明进行优先级排序。46名专家参与其中，包括来自六大洲的34名治疗内镜医师和12名内镜护士，女性占比45.6%（n = 21）。第一轮共产生了43条声明。其中，31条声明在第二轮后达成共识。这些声明被分为一般考虑（n = 6）、教育（n = 10）、妊娠（n = 4）、计划生育（n = 2）、患者安全（n = 4）和工作人员安全（n = 5）。在第三轮中，被接受的声明获得的平均优先级分数在7.28至9.36之间，87.2%的声明被评为非常高的优先级（平均分数≥9）。本研究提出了基于共识的关于在胃肠内镜检查中安全有效使用荧光透视的声明，涉及医护人员和患者的福祉。这些基于共识的声明旨在降低与辐射暴露相关的风险，同时保持荧光透视的益处，最终在医疗环境中促进安全文化。
