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Preoperative endoscopy: the impact on planned surgical procedures
S M Gooden1, R A Brigham, R M Satava
1Department of Surgery, Dwight David Eisenhower Army Medical Center, Fort Gordon, GA 30905.
The American Surgeon
|November 1, 1988
Summary
Preoperative endoscopy is valuable, with 20% of procedures revealing significant findings. These discoveries altered treatment plans for 10% of patients, improving surgical outcomes.
Area of Science:
- Gastroenterology
- Surgical Optimization
Background:
- Preoperative endoscopic evaluation is increasingly utilized before elective surgeries or invasive diagnostic procedures.
- Assessing the gastrointestinal (GI) tract preoperatively can identify conditions impacting surgical planning and patient outcomes.
Observation:
- A retrospective review of 1,504 endoscopic procedures over 2.5 years identified 296 (20%) performed for preoperative clearance.
- Among these preoperative endoscopies, 66 (22%) yielded positive findings relevant to surgical planning.
Findings:
- Twenty-nine patients (10% of all preoperative evaluations) experienced treatment alterations based on positive endoscopic findings.
- Indications included atypical GI symptoms, unrelated GI issues, history of GI disease, and segment-specific evaluation prior to surgery.
Implications:
- Judicious application of preoperative endoscopy, guided by specific indications, can significantly reduce adverse surgical outcomes.
- This practice supports informed surgical decision-making and enhances patient safety in elective procedures.