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Does Sedation Affect Examination of Esophagogastric Junction during Upper Endoscopy?

 Hyun Jik Lee  ;  Bun Kim  ;  Dong Wook Kim  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Yong Chan Lee  ;  Sang Kil Lee 
 YONSEI MEDICAL JOURNAL, Vol.56(6) : 1566-1571, 2015 
Journal Title
Issue Date
Adult ; Aged ; Barrett Esophagus ; Body Mass Index ; Endoscopy, Digestive System/instrumentation ; Endoscopy, Digestive System/methods* ; Esophagitis, Peptic/diagnosis* ; Esophagogastric Junction/pathology* ; Female ; Gastroesophageal Reflux/diagnosis* ; Hernia, Hiatal/diagnosis* ; Humans ; Male ; Middle Aged ; Retrospective Studies
Conscious sedation ; esophagogastric junction ; esophagogastroduodenoscopy
PURPOSE: During sedated esophagogastroduodenoscopy (EGD), patients may not be able to perform inspiration, which is necessary to examine the esophagogastric junction. Therefore sedation may affect diagnosis of gastroesophageal reflux-related findings. The aim of our study was to investigate the effect of sedation on diagnosis of gastroesophageal reflux-related findings during EGD. MATERIALS AND METHODS: This retrospective study evaluated 28914 patients older than 20 years who underwent EGD at our institution between January 2011 and December 2011. Ultimately, 1546 patients indicated for EGD for health check-up and symptom evaluation were included. RESULTS: There were 18546 patients who had diagnostic EGD: 10471 patients (56%) by non-sedated EGD and 8075 patients (43%) by sedated EGD. After statistical adjustment for age, sex, and body mass index, minimal change esophagitis, and hiatal hernia were significantly less frequently observed in the sedated EGD group [odds ratio (OR), 0.651; 95% confidence interval (CI), 0.586 to 0.722 and OR, 0.699; 95% CI, 0.564 to 0.866]. Nevertheless, there was no significant difference in other findings at the gastroesophageal junction, such as reflux esophagitis with Los Angeles classification A, B, C, and D or Barrett's esophagus, between the two groups. Similarly, there were no differences in early gastric cancer, advanced gastric cancer, and gastric ulcer occurrence. CONCLUSION: Sedation can impede the detection of minimal change esophagitis and hiatal hernia, but does not influence detection of reflux esophagitis of definite severity and Barrett's esophagus.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Bun(김번)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
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