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Endoscopia

On-line version ISSN 2444-6483Print version ISSN 0188-9893

Abstract

GARCIA-CONTRERAS, Luis Fernando  and  BLANCO-VELASCO, Gerardo. Marcadores de calidad en la valoración de intestino delgado mediante cápsula endoscópica en un centro de tercer nivel. Endoscopia [online]. 2019, vol.31, suppl.2, pp.465-469.  Epub Feb 14, 2022. ISSN 2444-6483.  https://doi.org/10.24875/end.m19000149.

Introduction:

Quality indicators (QI) are intended to standardize endoscopic procedures to provide better results. The QI for the evaluation of the small bowel (SB) with capsule endoscopy (CE) was recently published by the European Society of Gastrointestinal Endoscopy (ESGE). The intention of this study is to evaluate the ECs carried out in our center from January 2018 to June 2019 according to the recently established QI.

Objective:

To assess the adherence to the QI suggested by the ESGE for the evaluation of the SB through the use of CE in a third level center.

Material and methods:

A review of the EC carried out in our center in a period of 18 months was carried out. All CEs performed to assess SB in this period were included. EC studies were excluded to assess colon.

Results:

200 CE SB3 were included, QI were divided into pre, intra and post procedure. From the pre procedure, CE was performed with an adequate indication in 95.5%, fulfilling the suggested goal (≥ 95%). In those with medium digestive tract hemorrhage CE was performed early (<15 days) in 63.76% this below the suggested goal (≥ 90%). Among the QI established by the ESGE, the assessment of patients with a high risk of CE retention through Patency capsule was excluded because we do not have it. From the intra procedure indicators (reading) the degree of intestinal cleansing was evaluated by using validated scales (Park, Brotz, etc), having to obtain an adequate visualization in ≥ 95% of the CE, in our center the fulfillment of this indicator was 0% due to the lack of use of validated scales to assess intestinal cleansing in the endoscopy report. Complete visualization of SB was achieved in 85.5% of the cases, meeting the minimum goal established (≥ 80%). The diagnostic rate obtained was 54.5% complying with the minimum established goal (≥ 50%). In the realization of the endoscopic report, a structured terminology for endoscopic capsule (CEST) was used in 92% of this above the established goal (≥ 90%). The CE reading was performed at 15 fields per second in 100% of the cases fulfilling the suggested goal (≥95%). From the post-procedure indicators, an adequate delivery to device-assisted enteroscopy was performed at 63.01%, this below the minimum suggested goal (≥75%). Capsule retention was present in 1.5% of the cases, this within the recommended goal that is less than 2%.

Conclusions:

The goals established in 6 of the 9 QI evaluated were met. The feedback through the QI assessment allows us to evaluate the weak points in our evaluation to improve these in the future.

Keywords : Quality indicators; Capsule endoscopy; Small bowel.

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