Preoperative endoscopy: the impact on planned surgical procedures

Of 1,504 endoscopic procedures in a two and one half year period, 296 (20%) were performed prior to elective surgery or an invasive diagnostic procedure. From these "pre-op clearance" procedures, there were 66 (22%) positive findings. Due to these endoscopic findings, 29 patients (44% of positive findings or 10% of all pre-operative evaluations) had an alteration of planned treatment. The indications for preoperative endoscopy in these patients were: atypical symptoms of diagnosed gastrointestinal (GI) tract disease, symptoms of GI tract disease unrelated to an elective surgical procedure, history of prior GI tract disease which may complicate elective surgery, and evaluation of a portion of the GI tract prior to operating on that segment. Judicious use of preoperative endoscopy following the above guidelines can decrease adverse surgical outcomes.