Background and Aims

Outbreaks of transmission of infection related to endoscopy despite reported adherence to reprocessing guidelines warrant scrutiny of all potential contributing factors. Recent reports from ambulatory surgery centers indicated widespread significant occult damage within endoscope working channels, raising concerns regarding the potential detrimental impact of this damage on the adequacy of endoscope reprocessing.

Methods

We inspected working channels of all 68 endoscopes at our academic institution using a novel flexible inspection endoscope. Inspections were recorded and videos reviewed by 3 investigators to evaluate and rate channel damage and/or debris. Working channel rinsates were obtained from all endoscopes, and adenosine triphosphate (ATP) bioluminescence was measured.

Results

Overall endoscope working channel damage was rated as minimal and/or mild and was consistent with expected wear and tear (median 1.59 on our 5-point scale). Our predominant findings included superficial scratches (98.5%) and scratches with adherent peel (76.5%). No channel perforations, stains, or burns were detected. The extent of damage was not predicted by endoscope age. Minor punctate debris was common, and a few small drops of fluid were noted in 42.6% of endoscopes after reprocessing and drying. The presence of residual fluid predicted higher ATP bioluminescence values. The presence of visualized working channel damage or debris was not associated with elevated ATP bioluminescence values.

Conclusion

The flexible inspection endoscope enables high-resolution imaging of endoscope working channels and offers endoscopy units an additional modality for endoscope surveillance, potentially complementing bacterial cultures and ATP values. Our study, conducted in a busy academic endoscopy unit, indicated predominately mild damage to endoscope working channels, which did not correlate with elevated ATP values.

中文翻译：

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范围：使用新型高分辨率检查内窥镜对内窥镜工作通道进行内窥镜评估（带视频）

背景和目标

尽管据报道遵守后处理指南，但与内窥镜检查有关的感染传播传播仍需要仔细检查所有潜在的促成因素。非卧床手术中心的最新报告表明，内窥镜工作通道内存在广泛的隐匿性损伤，引起了人们对该损伤对内窥镜后处理充分性的潜在有害影响的担忧。

方法

我们使用一种新型的柔性检查内窥镜检查了我们学院内所有68台内窥镜的工作通道。记录了检查，并由3名调查人员审查了视频，以评估和评估通道损坏和/或碎片。从所有内窥镜获得工作通道冲洗液，并测量三磷酸腺苷（ATP）的生物发光。

结果

内窥镜对工作通道的总体损坏被评为最小和/或轻微，与预期的磨损相符（我们的5分制中位数为1.59）。我们的主要发现包括表面刮擦（98.5％）和带有粘附性果皮的刮擦（76.5％）。未检测到通道穿孔，污渍或烧伤。损坏的程度无法通过内窥镜年龄来预测。轻微的点状杂物很常见，经过重新加工和干燥后，在42.6％的内窥镜中发现了一些小液滴。残留液体的存在预示着更高的ATP生物发光值。可视化的工作通道损坏或碎片的存在与ATP生物发光值的升高无关。

结论

灵活的检查内窥镜可以对内窥镜工作通道进行高分辨率成像，并为内窥镜单元提供用于内窥镜监视的其他方式，从而可以补充细菌培养物和ATP值。我们的研究是在繁忙的学术内窥镜部门进行的，表明对内窥镜工作通道的损害较小，这与ATP值升高无关。