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KMID : 1038120170500030261
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Clinical Endoscopy
2017 Volume.50 No. 3 p.261 ~ p.269
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Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image
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Gong Eun-Jeong
Lee Jeong-Hoon
Jung Kyoung-Won
Cho Charles J.
Na Hee-Kyong
Ahn Ji-Yong
Jung Kee-Wook
Kim Do-Hoon
Choi Kee-Don
Song Ho-June
Lee Gin-Hyug
Jung Hwoon-Yong
Kim Jin-Ho
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Abstract
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Background/Aims: The detection of multifocal lesions is important for the successful management of gastric neoplasms. We investigated the characteristics of missed simultaneous lesions and the reason for the missed diagnoses.
Methods: A total of 140 patients who underwent repeat endoscopy before endoscopic resection between June 2013 and June 2014 were retrospectively reviewed. We classified simultaneous lesions into three groups based on a review of earlier images: group 1, no images of the location of simultaneous lesions were taken; group 2, no corresponding lesion was evident in the previous images; and group 3, simultaneous lesions were visible in the earlier images but a biopsy was not performed.
Results: Simultaneous lesions were found in 12 patients (8.6%) with 13 lesions, comprising 10 dysplasia (76.9%) and three adenocarcinoma (23.1%). Regarding the reasons for missed diagnoses, seven lesions (53.8%) were classified as group 3, five (38.5%) as group 1, and the remaining lesion (7.7%) as group 2. There were no significant differences in the characteristics of the patients with and without simultaneous lesions.
Conclusions: Lesions disregarded or unnoticed during endoscopic examination were the main reason for missed diagnosis of simultaneous lesions. Endoscopists should consider the possibility of simultaneous lesions and attempt to meticulously evaluate the entire gastric mucosa.
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KEYWORD
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Endoscopy, Stomach neoplasms, Quality
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