1
|
Coppelli L, Díaz LA, Riquelme A, Waeger C, Rollán A, Bellolio E, Araya JC, Villaseca MA, Villasmil M, Pérez G, Coppelli C. [Protocolized referral to endoscopy and Helicobacter pylori detected in stools aimed to decrease endoscopy waiting lists]. Rev Med Chil 2020; 147:1382-1389. [PMID: 32186598 DOI: 10.4067/s0034-98872019001101382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 11/18/2019] [Indexed: 11/17/2022]
Abstract
Background Chile has one of the highest mortality rates by gastric cancer (GC) worldwide. Primary prevention of GC and detection of pre-neoplastic and early neoplastic lesions should be a national priority. Aim To assess the impact of the protocolization of endoscopy referral and the use of H. pylori stool antigen test (HPSA) in the management of dyspepsia to decrease the waiting list for endoscopy and increase the detection of gastric pre-neoplastic and early neoplastic lesions. Material and Methods We included all patients referred to the Endoscopy Unit of a regional hospital, from January 2015 to December 2017. We also included patients with known pre-neoplastic lesions and all those with first degree relatives with GC. We implemented protocols for referral of patients with dyspepsia considering the use of HPSA test, prioritizing to endoscopy those with a higher risk of GC. Results A total of 4,641 endoscopies and 2,631 HPSA tests were carried out. After the adoption of these protocols, we observed a 52% decrease in the waiting time for endoscopy. The GC detection rate in this period was 1.8 to 3.1 cases per 100 endoscopies. After the adoption of the protocols, we observed a significant increase in early GC detection rate (from none in 2015 to 13% in 2017, p = 0.03). Conclusions The protocolization of the referral for endoscopy associated with widespread use of HPSA test in the management of patients with dyspepsia, are successful strategies to decrease waiting lists for endoscopy and optimize the detection rate of pre-neoplastic lesions and early GC.
Collapse
Affiliation(s)
- Luis Coppelli
- Unidad de Endoscopia, Hospital de Villarrica, Villarrica, Chile
| | - Luis Antonio Díaz
- Departamento de Gastroenterología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Arnoldo Riquelme
- Departamento de Gastroenterología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Waeger
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Antonio Rollán
- Unidad de Gastroenterología, Clínica Alemana de Santiago, Santiago, Chile
| | - Enrique Bellolio
- Departamento de Anatomía Patológica, Universidad de la Frontera, Temuco, Chile
| | - Juan Carlos Araya
- Departamento de Anatomía Patológica, Universidad de la Frontera, Temuco, Chile
| | | | | | - Gonzalo Pérez
- Unidad de Gestión,, Hospital de Villarrica, Villarrica, Chile
| | | |
Collapse
|