Endoscopy 2020; 52(S 01): S266-S267
DOI: 10.1055/s-0040-1704838
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Esophagus ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC MANIPULATION INDUCES MINIMAL BUT REAL CHANGE OF Z-LINE APPEARANCE DURING ROUTINE ESOPHAGOGASTRODUODENOSCOPY

SH Lee
1   Kangwon National University Hospital, Department of Internal Medicine, Chuncheon, Korea, Republic of
,
SJ Nam
1   Kangwon National University Hospital, Department of Internal Medicine, Chuncheon, Korea, Republic of
,
SC Park
1   Kangwon National University Hospital, Department of Internal Medicine, Chuncheon, Korea, Republic of
,
DH Choi
1   Kangwon National University Hospital, Department of Internal Medicine, Chuncheon, Korea, Republic of
,
CD Kang
1   Kangwon National University Hospital, Department of Internal Medicine, Chuncheon, Korea, Republic of
,
SJ Lee
1   Kangwon National University Hospital, Department of Internal Medicine, Chuncheon, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims We aimed to investigate the effect of endoscopic manipulation during esophagogastroduodenoscopy (EGD) on EGJ appearance and analyze whether this leads to significant changes on the grading of Los Angeles (LA) classification including minimal change.

Methods A total of 367 subjects were enrolled in this prospective observational study. Still images of EGJ were captured during insertion and withdrawal phase of EGD. All the image sets of EGJ were mixed randomly, and graded by two independent endoscopists. Grades of LA classification were compared between insertion and withdrawal phase.

Results LA classification was changed in 49 subjects (13.8%). Grades rated during withdrawal phase after full EGD evaluation were upgraded significantly compared with grades rated during insertion (p < 0.0001). Age, belching and retching were significantly associated with LA classification change.

Conclusions EGJ appearance is affected by endoscopic manipulation during EGD. We suggest evaluating EGJ during insertion before evaluating distal part, especially in the study of minimal or microscopic change of EG junction.