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Endoscopic Ruler for varix size measurement: A multicenter pilot study.
Yi-Fei Huang1, Sheng-Juan Hu2, Yang Bu2
1Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China.
World Journal of Gastrointestinal Endoscopy
|September 25, 2023
Summary
The Endoscopic Ruler is a safe and feasible device for measuring esophageal varices in cirrhosis patients. It shows moderate agreement with endoscopists and substantial interobserver agreement for diagnosing large varices.
Area of Science:
- Gastroenterology
- Medical Devices
- Clinical Measurement
Background:
- Cirrhosis and portal hypertension frequently lead to esophageal varices (OV).
- Accurate measurement of OV size is crucial for risk stratification and treatment decisions.
- Current methods for assessing OV size can be subjective.
Purpose of the Study:
- To evaluate the feasibility and safety of the novel Endoscopic Ruler device.
- To assess the agreement between Endoscopic Ruler measurements and endoscopist assessments of large OV.
- To determine the interobserver agreement for diagnosing large OV using the Endoscopic Ruler.
Main Methods:
- Prospective study involving 120 cirrhosis patients undergoing esophagogastroduodenoscopy (EGD) with the Endoscopic Ruler.
- Primary outcome: successful measurement of varix size.
- Secondary outcomes: adverse events, operation time, agreement with endoscopists, and interobserver agreement.
Main Results:
- The Endoscopic Ruler was used successfully in all 120 patients without adverse events.
- Median operation time was 3 minutes.
- Moderate agreement (kappa=0.52) was found between the Endoscopic Ruler and endoscopists for identifying large OV.
- Substantial agreement (kappa=0.77) was observed among observers using the Endoscopic Ruler.
Conclusions:
- The Endoscopic Ruler is a feasible and safe tool for measuring esophageal varices in patients with cirrhosis.
- This device has the potential to improve the consistency of the two-grade classification system for OV.
- Objective measurement with the Endoscopic Ruler may enhance clinical practice for managing patients with portal hypertension.
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