Henry Córdova, Irina Luzko, Javier Tejedor-Tejada, Edgar Castillo-Regalado, Eva Barreiro-Alonso, Pedro Delgado-Guillena, Pilar Diez Redondo, Martin Galdin, Ana García-Rodríguez, Luis Hernández, Ma Henar Núñez Rodríguez, Agustín Seoane, Javier Jiménez Sánchez, Joaquín Cubiella, Rodrigo Jover, Antonio Rodríguez-D'Jesús, Cautar El Maimouni, Leticia Moreira, Oswaldo Ortiz, Joan Llach, Gloria Fernández-Esparrach
{"title":"上消化道内窥镜检查中评估粘膜清洁度的巴塞罗那量表的前瞻性验证。","authors":"Henry Córdova, Irina Luzko, Javier Tejedor-Tejada, Edgar Castillo-Regalado, Eva Barreiro-Alonso, Pedro Delgado-Guillena, Pilar Diez Redondo, Martin Galdin, Ana García-Rodríguez, Luis Hernández, Ma Henar Núñez Rodríguez, Agustín Seoane, Javier Jiménez Sánchez, Joaquín Cubiella, Rodrigo Jover, Antonio Rodríguez-D'Jesús, Cautar El Maimouni, Leticia Moreira, Oswaldo Ortiz, Joan Llach, Gloria Fernández-Esparrach","doi":"10.1177/17562848251363873","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Some validated scales for assessing upper gastrointestinal (UGI) cleanliness have been developed, though none have been widely implemented.</p><p><strong>Objectives: </strong>To evaluate the association between the presence of clinically significant lesions (CSLs) in the UGI tract and mucosal cleanliness using the Barcelona Scale. The secondary objective includes assessing the safety of water lavage during esophagogastroduodenoscopy (EGD).</p><p><strong>Design: </strong>Multicenter prospective study conducted in 14 hospitals in Spain.</p><p><strong>Methods: </strong>From January 2022 to December 2023, patients undergoing EGD were included. After cleansing, the esophagus, fundus, corpus, antrum, and duodenum were scored from 0 (unassessable due to content) to 2 (fully visualized mucosa), with a maximum score of 10.</p><p><strong>Results: </strong>A total of 641 patients were included, and 3205 segments were assessed: 2594 scored \"2,\" 604 \"1,\" and 7 \"0.\" In 272 patients, 327 CSLs were identified: 93 (14.5%) in the esophagus, 223 (34.8%) in the stomach, and 11 (1.7%) in the duodenum. Only five cases of neoplasia were found, all in segments scored \"2\" (global score ⩾ 9). The CSL detection rates were 0%, 5.3%, and 11.4% for scores 0, 1, and 2, respectively (<i>p</i> < 0.001), with a significantly higher rate for score \"2\" compared to \"1\" (OR 2.29, 95% CI 1.57-3.34). Besides the degree of cleanliness, several factors were independently associated with CSL detection, including the use of a high-definition endoscope (OR 1.87, 95% CI 1.14-3.23), male sex (OR 1.54, 95% CI 1.1-2.17), and age ⩾58 years (OR 1.54, 95% CI 1.09-2.17).</p><p><strong>Conclusion: </strong>The Barcelona scale may be a valid instrument for assessing the quality of cleanliness during EGD in real clinical practice, as it improves the detection of CSL in the UGI.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251363873"},"PeriodicalIF":3.4000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357016/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prospective validation of the Barcelona scale for the assessment of mucosal cleanliness during upper gastrointestinal endoscopy.\",\"authors\":\"Henry Córdova, Irina Luzko, Javier Tejedor-Tejada, Edgar Castillo-Regalado, Eva Barreiro-Alonso, Pedro Delgado-Guillena, Pilar Diez Redondo, Martin Galdin, Ana García-Rodríguez, Luis Hernández, Ma Henar Núñez Rodríguez, Agustín Seoane, Javier Jiménez Sánchez, Joaquín Cubiella, Rodrigo Jover, Antonio Rodríguez-D'Jesús, Cautar El Maimouni, Leticia Moreira, Oswaldo Ortiz, Joan Llach, Gloria Fernández-Esparrach\",\"doi\":\"10.1177/17562848251363873\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Some validated scales for assessing upper gastrointestinal (UGI) cleanliness have been developed, though none have been widely implemented.</p><p><strong>Objectives: </strong>To evaluate the association between the presence of clinically significant lesions (CSLs) in the UGI tract and mucosal cleanliness using the Barcelona Scale. The secondary objective includes assessing the safety of water lavage during esophagogastroduodenoscopy (EGD).</p><p><strong>Design: </strong>Multicenter prospective study conducted in 14 hospitals in Spain.</p><p><strong>Methods: </strong>From January 2022 to December 2023, patients undergoing EGD were included. After cleansing, the esophagus, fundus, corpus, antrum, and duodenum were scored from 0 (unassessable due to content) to 2 (fully visualized mucosa), with a maximum score of 10.</p><p><strong>Results: </strong>A total of 641 patients were included, and 3205 segments were assessed: 2594 scored \\\"2,\\\" 604 \\\"1,\\\" and 7 \\\"0.\\\" In 272 patients, 327 CSLs were identified: 93 (14.5%) in the esophagus, 223 (34.8%) in the stomach, and 11 (1.7%) in the duodenum. Only five cases of neoplasia were found, all in segments scored \\\"2\\\" (global score ⩾ 9). The CSL detection rates were 0%, 5.3%, and 11.4% for scores 0, 1, and 2, respectively (<i>p</i> < 0.001), with a significantly higher rate for score \\\"2\\\" compared to \\\"1\\\" (OR 2.29, 95% CI 1.57-3.34). Besides the degree of cleanliness, several factors were independently associated with CSL detection, including the use of a high-definition endoscope (OR 1.87, 95% CI 1.14-3.23), male sex (OR 1.54, 95% CI 1.1-2.17), and age ⩾58 years (OR 1.54, 95% CI 1.09-2.17).</p><p><strong>Conclusion: </strong>The Barcelona scale may be a valid instrument for assessing the quality of cleanliness during EGD in real clinical practice, as it improves the detection of CSL in the UGI.</p>\",\"PeriodicalId\":48770,\"journal\":{\"name\":\"Therapeutic Advances in Gastroenterology\",\"volume\":\"18 \",\"pages\":\"17562848251363873\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357016/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Gastroenterology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17562848251363873\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562848251363873","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Prospective validation of the Barcelona scale for the assessment of mucosal cleanliness during upper gastrointestinal endoscopy.
Background: Some validated scales for assessing upper gastrointestinal (UGI) cleanliness have been developed, though none have been widely implemented.
Objectives: To evaluate the association between the presence of clinically significant lesions (CSLs) in the UGI tract and mucosal cleanliness using the Barcelona Scale. The secondary objective includes assessing the safety of water lavage during esophagogastroduodenoscopy (EGD).
Design: Multicenter prospective study conducted in 14 hospitals in Spain.
Methods: From January 2022 to December 2023, patients undergoing EGD were included. After cleansing, the esophagus, fundus, corpus, antrum, and duodenum were scored from 0 (unassessable due to content) to 2 (fully visualized mucosa), with a maximum score of 10.
Results: A total of 641 patients were included, and 3205 segments were assessed: 2594 scored "2," 604 "1," and 7 "0." In 272 patients, 327 CSLs were identified: 93 (14.5%) in the esophagus, 223 (34.8%) in the stomach, and 11 (1.7%) in the duodenum. Only five cases of neoplasia were found, all in segments scored "2" (global score ⩾ 9). The CSL detection rates were 0%, 5.3%, and 11.4% for scores 0, 1, and 2, respectively (p < 0.001), with a significantly higher rate for score "2" compared to "1" (OR 2.29, 95% CI 1.57-3.34). Besides the degree of cleanliness, several factors were independently associated with CSL detection, including the use of a high-definition endoscope (OR 1.87, 95% CI 1.14-3.23), male sex (OR 1.54, 95% CI 1.1-2.17), and age ⩾58 years (OR 1.54, 95% CI 1.09-2.17).
Conclusion: The Barcelona scale may be a valid instrument for assessing the quality of cleanliness during EGD in real clinical practice, as it improves the detection of CSL in the UGI.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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