VALIDATION OF PRIORITY CRITERIA FOR RESTARTING ENDOSCOPIC ACTIVITY AFTER THE FIRST WAVE OF COVID19 PANDEMIC IN SPAIN. THE ENDOPRIOR STUDY

Aims National Spanish societies (AEG-SEED) proposed priorization criteria for restarting the endoscopic activity after the first wave of COVID19 pandemic. The aim was to evaluate the diagnostic yield of esophagogastroduodenoscopies(EGD) and colonoscopies in symptomatic patients for detecting clinically relevant lesions(CRL)

Methods Retrospective analysis of endoscopy reports from activity restart (April-May 2020) up to December 2020 of 12 centers that prospectively used AEG-SEED (symptoms&signs list) priority criteria (high=P1, medium=P2, and low=P3). CRL (defined before data collection) were those lesions that required invasive (endoscopic/surgical)treatment, hospitalization and/or close follow-up. Urgent, surveillance, therapeutic and colorectal cancer (CRC) screening procedures were excluded

Results 2058 (981 EGD; 1077 colonoscopies) in 1900 patients (56% women;58±16 years) were registered. Elapsed time (months; median[IQR]) from request to procedure completion for P1, P2 and P3 were 3 (2-5), 4 (3-7) and 6 (4-8) respectively. Overall CRL rates in EGD and colonoscopies were 11% and 18% respectively. CRL rates of EGD in P1, P2, and P3 were 13%, 14%, and 6%; and 26%, 18%, and 12% of colonoscopies. Among CRL, 6(0.6%) upper cancers (3 gastric, 2 esophageal, 1 duodenal) and 35(3.2%) CRC were detected. CRL and CRC rates in patients with positive, not-performed and negative fecal occult blood test (FOBT) were 31% and 9%, 17% and 2%, 10% and 0 respectively

Table 1

FOBT performed in a non-protocolized fashion*	Positive FOBT*n = 180 (%)	FOBT not-performed n=800 (%)	Negative FOBT*n =97 (%)
CRL	55 (31)	133 (17)	10 (10)
–CRC	16 (9)	19 (2)	0
–Advanced adenoma/serrated lesion	25 (14)	60 (8)	6 (6)
–Non-neoplastic lesions	14 (8)	42 (5)	4 (4)

Fig. 1

Conclusions AEG-SEED priority criteria identified those symptomatic patients with higher-risk of having CRL in colonoscopies according to priority level, with a higher diagnostic yield according to FOBT results. Optimize priorization is especially needed for EGD to manage waiting lists in open-access endoscopy units

Publication History

Article published online:
14 April 2022