Abstract
Background and study aims Esophagogastroduodenoscopy (EGD) has utility in early detection of upper gastrointestinal
(UGI) neoplasms. However, previous studies report shorter inspection times and inexperienced
endoscopists contribute to overlooking gastric neoplasms. We investigated neoplasm
detection rates according to inspection time and extent of EGD training.
Patients and methods In this retrospective observational study, we reviewed routine EGDs for 3,925 consecutive
cases between October 2014 and March 2015. We divided the endoscopists into three
groups based on median inspection time during EGD without undergoing biopsy. Using
cut-off median inspection times of 7 and 10 minutes, three, five, and eight endoscopists
were classified into the fast, moderate, and slow groups, respectively. We compared
detection rates according to inspection time and the extent of EGD training.
Results The median inspection time among all endoscopists was 9.3 minutes (range, 6.6 – 12.0 min).
The detection rate for UGI neoplasms was as follows: fast group, 3.6%; moderate group,
3.3 %; and slow group, 3.1 % (P = 0.807). The median inspection time was significantly shorter among the intensive
training ≥ 1-year group than among the < 1-year group (< 1-year: median 6.3 min; range
8.2 – 13.9 min, ≥ 1-year: median 8.9 min; range 6.4 – 11.4 min, P < 0.001). The detection rate for UGI neoplasms was significantly higher among the
intensive training ≥ 1-year group than among the < 1-year group (< 1-year: 2.2 %;
≥ 1-year: 3.7 %, OR = 1.65, 95 % CI: 1.02 – 2.68, P = 0.041).
Conclusions There was no association between inspection times and neoplasm detection rates. The
quality of EGD, as measured by neoplasm detection rates, may be improved by ≥ 1-year
of intensive training.
