HOW LONG TIME SHOULD AN ESOPHAGOGASTRODUODENOSCOPY BE DONE?

Aims: Esophagogastroduodenoscopy (EGD) is commonly used to detect upper gastrointestinal (GI) neoplasms. However, it is not clear how the time of EGD affects the detection of cancer or premalignant lesions that increase the risk for GI cancer. We investigate whether differences in endoscopy exam time of cancer affect cancer detection rates. Methods: We performed a retrospective analysis of data from 24,604 subjects who underwent EGD as part of a comprehensive health-screening program from January 2016 to December 2016 in Korea. Endoscopy findings were extracted from reports prepared by 9 board-certified endoscopists. Endoscopists were classified as fast, moderate or slow based on their mean examination time for a normal EGD without biopsy during their first year of the study. All endoscopists used the same endoscopy unit. Results: Mean examination time of EGD without biopsy was 3.9 min (range, 2 – 14 min). When cut-off times of 3 and 7 min were used, three endoscopists were classified into the fast (mean duration, 2.6 ± 1.0 min), 4 into the moderate (3.8 ± 1.4 min), and two into the slow (7.2 ± 1.3 min) groups. Neoplastic lesion detection rates in the fast, moderate, and slow groups were 0.95%, 0.96%, and 0.95%, respectively. There was no statistical difference in the detection rate. The rate of complications such as Mallory-Weiss tear was higher in slow group. Conclusions: Examination time is important in endoscopy. However, a simple increase in the examination time did not increase the detection rate of precancerous lesions. It is important to more detail observation about the suspicious lesion during the examination and to learn the blind spot test. Further research is needed in the future.