An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

Chiu, Philip Wai Yan and Uedo, Noriya and Singh, Rajvinder and Gotoda, Takuji and Ng, Enders Kwok Wai and Yao, Kenshi and Ang, Tiing Leong and Ho, Shiaw Hooi and Kikuchi, Daisuke and Yao, Fang and Pittayanon, Rapat and Goda, Kenichi and Lau, James Y W and Tajiri, Hisao and Inoue, Haruhiro (2018) An Asian consensus on standards of diagnostic upper endoscopy for neoplasia. Gut, 68 (2). pp. 186-197. ISSN 0017-5749

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Official URL: https://doi.org/10.1136/gutjnl-2018-317111

Abstract

Background This is a consensus developed by a group of expert endoscopists aiming to standardise the preparation, process and endoscopic procedural steps for diagnosis of early upper gastrointestinal (GI) cancers. Method The Delphi method was used to develop consensus statements through identification of clinical questions on diagnostic endoscopy. Three consensus meetings were conducted to consolidate the statements and voting. We conducted a systematic literature search on evidence for each statement. The statements were presented in the second consensus meeting and revised according to comments. The final voting was conducted at the third consensus meeting on the level of evidence and agreement. Results Risk stratification should be conducted before endoscopy and high risk endoscopic findings should raise an index of suspicion. The presence of premalignant mucosal changes should be documented and use of sedation is recommended to enhance detection of superficial upper GI neoplasms. The use of antispasmodics and mucolytics enhanced visualisation of the upper GI tract, and systematic endoscopic mapping should be conducted to improve detection. Sufficient examination time and structured training on diagnosis improves detection. Image enhanced endoscopy in addition to white light imaging improves detection of superficial upper GI cancer. Magnifying endoscopy with narrow-band imaging is recommended for characterisation of upper GI superficial neoplasms. Endoscopic characterisation can avoid unnecessary biopsy. Conclusion This consensus provides guidance for the performance of endoscopic diagnosis and characterisation for early gastric and oesophageal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early upper GI cancers.

Item Type: Article
Uncontrolled Keywords: endoscopy; gastric neoplasia; oesophageal cancer
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 22 Jan 2019 03:38
Last Modified: 22 Jan 2019 03:38
URI: http://eprints.um.edu.my/id/eprint/20093

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