Background and Aims

During endoscopy, droplets with the potential to transmit infectious diseases are known to emanate from a patient’s mouth and anus, but they may also be expelled from the biopsy channel of the endoscope. The main goal of our study was to quantify droplets emerging from the biopsy channel during clinical endoscopy.

Methods

A novel light-scattering device was used to measure droplets emanating from the biopsy channel. An endoscopy model was created, and in vitro measurements were carried out during air insufflation, air and water suctioning, and the performance of biopsy sampling. Similar measurements were then made on patients undergoing endoscopy, with all measurements taking place over 2 days to minimize variation.

Results

During in vitro testing, no droplets were observed at the biopsy channel during air insufflation or air and water suctioning. In 3 of 5 cases, droplets were observed during biopsy sampling, mostly when the forceps were being removed from the endoscope. In the 22 patients undergoing routine endoscopy, no droplets were observed during air insufflation and water suctioning. Droplets were detected in 1 of 11 patients during air suctioning. In 9 of 18 patients undergoing biopsy sampling and 5 of 6 patients undergoing snare polypectomies, droplets were observed at the biopsy channel, mostly when instruments were being removed from the endoscope.

Conclusions

We found that the biopsy channel may be a source of infectious droplets, especially during the removal of instruments from the biopsy channel. When compared with droplets reported from the mouth and anus, these droplets were larger in size and therefore potentially more infectious.

中文翻译：

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内窥镜活检通道作为胃肠道内窥镜检查期间传染性飞沫的潜在来源

 背景和目标

在内窥镜检查过程中，已知患者的口腔和肛门会散发出具有传播传染病潜力的飞沫，但它们也可能会从内窥镜的活检通道中排出。我们研究的主要目标是量化临床内窥镜检查过程中从活检通道产生的液滴。

 方法

使用一种新颖的光散射装置来测量从活检通道发出的液滴。创建了内窥镜模型，并在充气、抽气和吸水以及活检取样过程中进行了体外测量。然后对接受内窥镜检查的患者进行类似的测量，所有测量都在 2 天内进行，以尽量减少变化。

 结果

在体外测试中，在吹气或抽吸空气和水时，在活检通道处未观察到液滴。 5 例中有 3 例在活检取样期间观察到液滴，主要是在从内窥镜中取出镊子时。 22例常规内镜检查患者在吹气和吸水过程中均未观察到飞沫。 11 名患者中有 1 名在抽气过程中检测到飞沫。 18 名接受活检取样的患者中有 9 名以及接受圈套器息肉切除术的 6 名患者中有 5 名在活检通道处观察到液滴，主要是在从内窥镜中取出器械时。

 结论

我们发现活检通道可能是传染性飞沫的来源，特别是在从活检通道取出器械的过程中。与从口腔和肛门报告的飞沫相比，这些飞沫尺寸更大，因此可能更具传染性。