{"id":2091,"date":"2018-10-20T18:40:28","date_gmt":"2018-10-20T16:40:28","guid":{"rendered":"https:\/\/angh.net\/abstracts\/lendoscopie-digestive-sous-ag-dans-les-centres-hospitaliers-generaux-chg-en-2018-etude-descriptive-de-pratique-angh-dans-84-chg\/"},"modified":"2018-11-29T11:21:24","modified_gmt":"2018-11-29T10:21:24","slug":"lendoscopie-digestive-sous-ag-dans-les-centres-hospitaliers-generaux-chg-en-2018-etude-descriptive-de-pratique-angh-dans-84-chg","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/lendoscopie-digestive-sous-ag-dans-les-centres-hospitaliers-generaux-chg-en-2018-etude-descriptive-de-pratique-angh-dans-84-chg\/","title":{"rendered":"L\u2019endoscopie digestive sous AG dans les centres hospitaliers g\u00e9n\u00e9raux (CHG) en 2018 : Etude descriptive de pratique ANGH dans 84 CHG."},"content":{"rendered":"

2018<\/strong><\/p>\n

Gilles Macaigne (1), Jean Pierre Arpurt (2), Ren\u00e9 Louis Vitte (3), Bruno Lesgourgues (4).
\n(1) Marne la Vall\u00e9e, (2) Avignon, (3) Poissy sur Seine, (4) Montfermeil.<\/em><\/p>\n

Vie Professionnelle <\/strong>– \u00a02018-05-03 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Introduction \u2013 Objectifs
\nLes modalit\u00e9s d\u2019organisation de l\u2019endoscopie digestive sous AG (EDAG) dans nos CHG paraissent tr\u00e8s h\u00e9t\u00e9rog\u00e8nes. Cette activit\u00e9 peut \u00eatre localis\u00e9e dans une unit\u00e9 d\u00e9di\u00e9e d\u2019endoscopie digestive, dans un bloc op\u00e9ratoire central ou dans un bloc ambulatoire polyvalent. Les r\u00e9sultats et interpr\u00e9tations de cette enqu\u00eate \u00abminute \u00bb ont pour objectifs d\u2019effectuer un \u00e9tat des lieux des pratiques de l\u2019EDAG dans nos CHG et pour chacun d\u2019entre nous, d\u2019apporter des \u00e9l\u00e9ments concrets dans les discussions men\u00e9es avec nos administrations.
\nMalades et M\u00e9thodes
\nUn formulaire en ligne a \u00e9t\u00e9 adress\u00e9 \u00e0 298 services d\u2019H\u00e9pato-Gastro-Ent\u00e9rologie ou \u00e0 orientation gastroent\u00e9rologique de centres ANGH. Deux relances ont \u00e9t\u00e9 effectu\u00e9es en l\u2019absence de r\u00e9ponse. Le questionnaire permettait d\u2019\u00e9valuer le volume annuel d\u2019endoscopies digestives sous AG et la nature des endoscopies interventionnelles r\u00e9alis\u00e9es, les modalit\u00e9s d\u2019organisation et d\u2019encadrement des unit\u00e9s d\u2019endoscopies digestives, le degr\u00e9 de satisfaction des praticiens en fonction de l\u2019organisation en place.
\nR\u00e9sultats
\nLes donn\u00e9es concernant 84 centres (28%) ont \u00e9t\u00e9 recueillies et analys\u00e9es. Les centres \u00e9taient r\u00e9partis en fonction du nombre annuel d\u2019endoscopies r\u00e9alis\u00e9es sous AG : Moins de 1000 : 13 (15%) ; Entre 1000 et 2000 : 25 (30%) ; Entre 2000 et 3000 : 28 (33%) ; Plus de 3000 : 18 (22%). 61 centres (73%) ont une activit\u00e9 d\u2019endoscopie digestive interventionnelle : CPRE dans 46 centres (55%), dilatation et pose d\u2019endoproth\u00e8ses dans 60 centres (71%), dissection sous muqueuse dans 12 centres (14%) et \u00e9cho-endoscopies avec ponction-biopsie dans 37 centres (44%).
\nLes endoscopies sous AG sont r\u00e9alis\u00e9es au bloc op\u00e9ratoire central dans 52 centres (62%), dont 39 (75%) dans une salle d\u00e9di\u00e9e, dans un bloc endoscopique d\u00e9di\u00e9 dans 29 centres (34%), dont 18 (62%) attach\u00e9 au bloc central et dans un bloc ambulatoire polyvalent dans 3 centres (4%). L\u2019EDAG est significativement plus souvent organis\u00e9e au bloc op\u00e9ratoire central dans les centres ayant une plus faible activit\u00e9 ( 3000 endos sous AG \/ an), respectivement 92% et 50% (p < 0,05).
\nEn cas d\u2019activit\u00e9 au bloc op\u00e9ratoire, la gestion des programmes est assur\u00e9e en totalit\u00e9 par l\u2019\u00e9quipe d\u2019endoscopie dans 62% des cas, \u00ab l\u2019aide endoscopiste \u00bb et la gestion des endoscopes \u00e9tant assur\u00e9es par l\u2019\u00e9quipe d\u2019endoscopie (IDE, AS) dans respectivement 63% et 82% des cas.
\nBien que 52% des gastro-ent\u00e9rologues ayant leur activit\u00e9 d\u2019EDAG au bloc op\u00e9ratoire estiment que le bloc op\u00e9ratoire central n\u2019est pas adapt\u00e9 \u00e0 l\u2019EDAG, les taux de satisfaction de l\u2019activit\u00e9 endoscopique sous AG n\u2019\u00e9taient pas diff\u00e9rents entre le bloc op\u00e9ratoire central et le bloc endoscopique d\u00e9di\u00e9.
\nUne pression administrative quant \u00e0 l\u2019activit\u00e9 des endos sous AG est not\u00e9e dans respectivement 31% et 40% des centres avec activit\u00e9 au bloc d\u2019endoscopies et au bloc op\u00e9ratoire (NS). Le co\u00fbt de l\u2019activit\u00e9 n\u2019est connu que d\u2019une minorit\u00e9 des gastro-ent\u00e9rologues.
\nConclusion
\nDans la majorit\u00e9 des centres ANGH ayant particip\u00e9, l\u2019activit\u00e9 d\u2019EDAG est organis\u00e9e au bloc op\u00e9ratoire central (62%) avec un taux de satisfaction identique \u00e0 celui des centres faisant les endos sous AG dans un bloc d\u2019endoscopie ou dans un bloc ambulatoire polyvalent. La gestion de cette activit\u00e9 est assur\u00e9e dans plus de 60% des cas par les \u00e9quipes d\u2019endoscopie elles m\u00eames. Malgr\u00e9 une pression administrative ressentie dans plus d\u2019un tiers des centres, seule une minorit\u00e9 d\u2019entre nous conna\u00eet les co\u00fbt d\u2019activit\u00e9 de l\u2019EDAG, tr\u00e8s variables d\u2019un centre \u00e0 l\u2019autre.<\/p>\n[download id=\u00a0\u00bb2235″]\n","protected":false},"excerpt":{"rendered":"

2018 Gilles Macaigne (1), Jean Pierre Arpurt (2), Ren\u00e9 Louis Vitte (3), Bruno Lesgourgues (4). (1) Marne la Vall\u00e9e, (2) Avignon, (3) Poissy sur Seine, (4) Montfermeil. Vie Professionnelle – \u00a02018-05-03 –\u00a0CO – ________________________________ Introduction \u2013 Objectifs Les modalit\u00e9s d\u2019organisation de l\u2019endoscopie digestive sous AG (EDAG) dans nos CHG paraissent tr\u00e8s h\u00e9t\u00e9rog\u00e8nes. Cette activit\u00e9 peut […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[5],"tags":[29],"class_list":["post-2091","post","type-post","status-publish","format-standard","hentry","category-professionnel","tag-29"],"yoast_head":"\nL\u2019endoscopie digestive sous AG dans les centres hospitaliers g\u00e9n\u00e9raux (CHG) en 2018 : Etude descriptive de pratique ANGH dans 84 CHG. - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/lendoscopie-digestive-sous-ag-dans-les-centres-hospitaliers-generaux-chg-en-2018-etude-descriptive-de-pratique-angh-dans-84-chg\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"L\u2019endoscopie digestive sous AG dans les centres hospitaliers g\u00e9n\u00e9raux (CHG) en 2018 : Etude descriptive de pratique ANGH dans 84 CHG. - 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