Invited Lecture(JGES)
Fri. November 6th   11:30 - 12:00   Room 5: Portopia Hotel South Wing Ohwada A
Invited Lecture7
 Complete photodocumentation of the upper GI tract: Would it be possible in clinical practice?
Fabian Emura
Division of Gastroenterology, Universidad de La Sabana
Background and Aim
Complete photodocumentation has been proposed as an indicator of EGD completeness. There are no reports, however, on its clinical feasibility. We aim to determine the feasibility, endoscopic findings and procedure times of complete photodocumentation during EGD in 161 consecutive patients examined at EmuraCenter LatinoAmerica, Bogotá, Colombia.
Material and Methods
Examinations were performed by an expert (FE) and two trainee endoscopists (J.T-C and D.C-Z). Procedures were performed using an EG 760Z gastroscope and a Fuji 7000 video processor (Fujifilm, Japan). Images were captured from a 32GB USB memory card and then, manually transferred to a computer. The upper GI tract was divided into 28 areas according to Emura et al. Photodocumentation was graded as complete, 28 areas registered, 100% of the mucosal framework and, incomplete, less than 28 areas registered, <100% of the mucosal framework. Inspection time was defined as the time between photodocumentation of the hypopharynx, área 1, and the 2nd duodenal portion, área 28. Total procedure time was defined as the time between photodocumentation of the hypopharynx and the withdrawal of the endoscope. Sequential photodocumentation was defined as the consecutive image registry from area 1 to area 28. A non-sequential exam was defined as an exam when the ordered image registry was interrupted. All captured images were reviewed by two independent endoscopists (C.R-R and O.M), to ensure images were sequentially registered and truly corresponded to described areas.
Results
The mean patient age was 62 years and the female:male was 2.4:1. There were one early and one advanced gastric cancer diagnosed in each group. There were no differences in clinicopatological data among the groups. Overall complete photodocumentation was achieved 93% of cases, 94% and 92% in the expert and trainee groups, respectively (NS). The Brennan adjusted Kappa coefficient was 0.88 (95%CI: 0.79-0.96, P: < 0.001). Sequential photodocumentation was obtained in 93% of cases in both groups. The Brennan adjusted Kappa coefficient was 0.88 (95%CI: 0.79-0.96, P: < 0.001). Inspection times were 4 minutes, 5 seconds and 5 minutes, 11 seconds, in the expert and trainee groups, respectively (NS). Meanwhile, total procedure times were 7 minutes, 46 seconds and, 7 minutes, 55 seconds, in the expert and trainee groups, respectively (NS).
Conclusion
Complete and sequential photodocumentation during EGD can be achieved in almost all cases with excellent procedures times regardless of the examiner's experience.
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