Sa1038 HIGH COST FOR LOW YIELD: A SYSTEMATIC REVIEW TO ASSESS THE COST-EFFECTIVENESS OF ROUTINE PRE-OPERATIVE ESOPHAGOGASTRODUODENOSCOPY (EGD) BEFORE BARIATRIC SURGERY

Interventions for the Management of Post–Sleeve GERD

“…17 On the other hand, Evans et al published a systematic review and meta-analysis looking at 31 observational studies noting that 3.9% of patients who underwent preoperative endoscopy had a change in surgical procedure based on findings. 18 This number went down to only 0.3% after they adjusted for sensitivity, as the majority of these patients were found to have a HH, thus questioning the feasibility of routine preoperative endoscopy. 18 While the indications for preoperative endoscopy may not be clear, most agree that erosive esophagitis (EE) and BE are relative contraindications for SG.…”

“…18 This number went down to only 0.3% after they adjusted for sensitivity, as the majority of these patients were found to have a HH, thus questioning the feasibility of routine preoperative endoscopy. 18 While the indications for preoperative endoscopy may not be clear, most agree that erosive esophagitis (EE) and BE are relative contraindications for SG. 19,20 These findings highlight the importance of having an individualized approach for every patient undergoing SG.…”

Actualidades sobre el manejo endoscópico en complicaciones derivadas de la cirugía bariátrica

“…En cuanto a la evaluación preoperatoria existen distintos puntos de vista sobre la realización de endoscopía preoperatoria entre las guías europeas, que la indican de manera rutinaria 2 , y las guías americanas que no la indican de manera estricta 3 . Una revisión sistemática realizada por Evans, et al en la universidad de Washington demostró que en el 7.3% de los pacientes en quienes se realizó la endoscopía preoperatoria hubo cambio en el plan quirúrgico secundario a alguna alteración y que el costo por endoscopía diagnóstica fue de 22,142 dólares 4 ; en contraste con nuestro medio el realizar estudios endoscópicos en los cuales se puedan diagnosticar patologías desde esofagitis hasta tumores, a un costo que no se equipara al costo de…”