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Title: Validation of a new method for the endoscopic measurement of post-bariatric gastric outlet using a standard guidewire: an observer agreement study
Other Titles: BMC Research Notes
Authors: Falcão de Santana, Marcelo
de Quadros, Luiz Gustavo
dos Passos Galvão Neto, Manoel
Marins Campos, Josemberg
Kaiser Junior, Roberto Luiz
Grecco, Eduardo
Flamini Junior, Mario
Zotarelli Filho, Idiberto Jose
Tomas Vasconcelos Almeida Alexandre, Adriano Augusto
Keywords: Gastric outlet; Observer agreement; Measurement reliability; Weight regain; Weight recidivism; Upper endoscopy
Issue Date: Jan-2017
Abstract: Between 10 and 20% of all patients undergoing bariatric surgery procedures regain weight secondary to a gastrojejunostomy enlargement. The aim of this study was to validate the interobserver greement while measuring gastric outlet diameters using a new standard guidewire. Methods We selected thirty-five videos of consecutive endoscopic procedures on patients undergoing esophagogastroduodenoscopy after a Roux-en-Y gastric bypass procedure. All videos were evaluated by four raters: two expert endoscopists and two trainees. We excluded videos having a slipped Fobi ring or a strictured gastric outlet. Anastomosis diameter was measured using a novel device with standardized markings on a guidewire (Hydra jagwire, Boston Scientific, Natick. MA) as well as the current gold standard defined as a calibrated endoscopic measuring instrument (Olympus America, Center Valley, PA). Results We obtained 272 measurements of the gastric outlet. Overall agreement measured through intra-class correlation coefficients for the gold standard was 0.84 (p < 0.01) and 0.83 (p < 0.01) for the new guidewire. Agreement among experts was 0.699 (p < 0.01), while among trainees it was 0.822 (p < 0.01). Conclusion The new guidewire demonstrated a high degree of observer reliability, also presenting similar results between expert endoscopists and trainees.
ISSN: 1756-0500
Appears in Collections:Artigos Completos Publicados em Periódicos

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