Glenn M Ihde1*, Leah A Dill2 , Danny G Lister3 , Christopher F Lucchese4 , Christopher Cottrell5 , Peter K Krone6 and Ramsey A Stone7
1 Ihde Surgical Group, Mayfield, USA 2 Texas Bariatric Specialists, USA 3 The Surgical Clinic of Central Arkansas, USA 4 Texas Health Physicians Group/Texas Health Presbyterian-Wilson N. Jones Hospital, USA 5 North Dallas Surgical Specialists, USA 6 PA, Granbury, USA 7 North Texas Surgery, USAFulltext PDF
Background: This study assesses the intra-rater agreement of assigning Hill grade to pre-operative endoscopy under Intravenous Sedation (IVS) versus under General Anesthesia (GA). Methods: Fifty-three patients studied prospectively underwent both a preoperative endoscopy under IVS and a second endoscopy under GA just prior to surgery. These endoscopies were recorded and eight general surgeons experienced reflux surgery evaluated each endoscopy. Intrarater agreement was assessed by comparing Hill grade assessment of the GEJ under IVS versus their Hill grade assessment under GA. Results: There was a significant difference in assigning Hill grades under IVS versus GA in seven raters. Significantly, Hill grade was larger under IVS in 43% of cases. Conclusion: In this study, type of anesthesia affected the endoscopic assessment of the GEJ, favoring a larger Hill grade assignment under IVS than GA
Gastroesophageal; Reflux; Hiatal hernia; Endoscopic; Endoluminal; Fundoplication; Transoral
Ihde GM, Dill LA, Lister DG, Lucchese CF, Cottrell C, Krone PK, et al. Type of Anesthesia Affects the Assessment of Gastroesophageal Junction in Patients Evaluated for Anti-Reflux Surgery. Clin Surg. 2020; 5: 3003..