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Jiao Y, Cheng Z, Gao Y, Wang T, Xin L, Lin H, Cai M, Ma X, Li Z, Wang L. Development and status quo of digestive endoscopy in China: An analysis based on the national census in 2013 and 2020. J Transl Int Med 2024; 12:177-187. [PMID: 38779123 PMCID: PMC11107185 DOI: 10.2478/jtim-2023-0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background and Objectives Technique and practice of digestive endoscopy are undergoing speedy development all over the world. This study aimed to evaluate its status quo and development in China. Methods All hospitals performing digestive endoscopy in mainland China participated in the national census in 2013 and 2020. Retrospective data of hospitals, endoscopists, volumes, and qualities were collected via an online structured questionnaire, and its accuracy and rationality were verified by logical tests and manual reviews. Data from other countries were used to compare with that of China. Results From 2012 to 2019, the number of hospitals performing digestive endoscopy increased from 6,128 to 7,470 (1.22-fold), in which primary healthcare played a minor role. The median hospitals per 100,000 inhabitants per provincial region increased from 0.49 (IQR, 0.39-0.57) to 0.55 (IQR, 0.49-0.63). The endoscopists increased from 26,203 to 39,638 (1.51-fold), but their average workload even expanded. Overall volume increased from 28.8 million to 44.5 million (1.55-fold), and most types of endoscopic procedures recorded a high growth rate. Contrastingly, the specific utilization rates were low and paled in comparison with some developed countries. Nationwide, regional utilization rates showed a significant correlation with GDP per capita (P <0.001). Overall qualities of digestive endoscopy were excellent, but certain results of quality indicators posed a huge challenge, such as the detection rates of adenoma and early cancers. Conclusions Impressive progress has been made in digestive endoscopy with rapidly expanding economy in China. However, primary healthcare, utilization rates, and income-related inequality of regional services were needed to be improved to promote public health better.
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Affiliation(s)
- Yunfei Jiao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
| | - Zhiyuan Cheng
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200240, China
| | - Ye Gao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
| | - Tianjiao Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
| | - Lei Xin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
| | - Han Lin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
| | - Mengxi Cai
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
| | - Xudong Ma
- Department of Medical Quality, Medical and Health Administration, National Health Commission of China, Beijing100044, China
| | - Zhaoshen Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
| | - Luowei Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai200433, China
- National Digestive Endoscopy Improvement System, Shanghai200433, China
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Santiana L, Kusuma FF. A rare case of mega-esophagus due to achalasia causing tracheal compression. Radiol Case Rep 2024; 19:39-43. [PMID: 38046914 PMCID: PMC10692489 DOI: 10.1016/j.radcr.2023.09.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 12/05/2023] Open
Abstract
Achalasia is one of the most common esophageal motility disorders. Typical symptoms include dysphagia, food regurgitation, respiratory symptoms, chest pain, and weight loss. Respiratory obstruction due to tracheal compression by the massively dilated esophagus is a very rare but fatal complication. A 36-year-old male presented with progressive respiratory distress with a history of untreated dysphagia and regurgitation. Further diagnosis revealed dilatation of the esophagus with undigested food. A Heller myotomy with fundoplication was performed and respiratory symptoms were relieved. Tracheal compression and acute airway obstruction caused by esophageal dilatation in achalasia is a rare presentation. Early recognition of this rare manifestation is critical and emergency treatment is necessary for life saving. Radiological examination can help physicians find the dilated esophagus. Respiratory symptoms resulting from tracheal compression by a dilated esophagus rarely occurred. Even though physicians should be alert and early decompression has to be performed immediately.
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Affiliation(s)
- Leni Santiana
- Department of Radiology, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
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