ABSTRACT

The aim of this study is to evaluate cognitive competence of surgeon-endoscopists in esophagogastroduodenoscopy (EGD) by comparison between endoscopic and pathologic diagnosis.

This study is a retrospective chart review of 257 EGDs performed between September 2008 and March 2010 by two attending surgeons (OI, FAG) at the Zonguldak Karaelmas University, Medical Faculty, Department of General Surgery. Cognitive competence was examined by comparison between endoscopic and histopathological diagnosis. Endoscopic and pathologic reports were collected from the hospital database.

217 of 257 EGDs were evaluated. Demographic data of the patients showed that 36% were male and 64% were female. The mean age was 51 years with a range of 24 to 78 years. Endoscopic diagnosis was gastritis in 78% of patients (n=168) and suspicion of malignancy in 11% (n=25). After histopathologic examination, 142 out of 168 patients with endoscopically suspected gastritis were diagnosed as having chronic gastritis or chronic-active gastritis. Surgeons were able to identify an abnormality with a detection rate of 86%. Surgeon-endoscopists had 80% positive predictive and 100% negative predictive value for malignancy according to EGD findings. H. pylori-positive gastric mucosal pattern was accurately identified by surgeons, and the infection was found in 67% (n=112) of patients with chronic gastritis or chronic-active gastritis.

Taking into consideration the good agreement observed between endoscopic and pathologic findings in our study, we may conclude that surgeon-endoscopists with high cognitive competence in EGD may establish accurate diagnosis.