title: Landmark reading alterations in patients with gastro-oesophageal reflux symptoms undergoing diagnostic gastroscopy.
abstract: OBJECTIVE
  There is still a debate about the exact measurement of the oesophagogastric junction and the diaphragmatic hiatus among clinicians. The aim of this study was to investigate the differences between landmark readings of gastroscopy on intubation and extubation, and to correlate these readings with a gastro-oesophageal reflux questionnaire.
  
  
  METHODS
  116 cases who underwent diagnostic gastroscopy between January 2013 and June 2013 were included in this study. Landmark measurements were noted while withdrawing the endoscope and were also evaluated after the gastric air was fully emptied. We first used a frequency scale for the gastro-oesophageal reflux disease symptoms (FSSG) questionnaire in order to investigate dysmotility and acid reflux symptoms in the study population and correlated the FSSG questionnaire with intubation and extubation measurements at endoscopic examination.
  
  
  RESULTS
  Mean age of included subjects was 49.41±17.7 (19-82) years. Males and females were equally represented. On FSSG scores, the total dysmotility score was 7.99±5.06 and the total score was 15.18±10.11. The difference between intubation and extubation measurements ranged from -3cm to +2cm (mean: -0.4). When an FSSG score of 30 was accepted as a cut-off value, we detected a significant difference between the measurements (p<0.05; t: 0.048).
  
  
  CONCLUSIONS
  Accuracy of landmark measurements during gastroscopy is clearly affected from insertion or withdrawal of the endoscope. When differences in measurements between insertion and withdrawal were evident, comparable with the FSSG scores, the results became significantly different. In conclusion, according to FSSG scores, these measurements should be performed at the end of the endoscopy.
authors.affiliation: GATA Haydarpasa Training Hospital, Internal Medicine Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: dr_mustafakaplan@yahoo.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kaplan
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: alpaslantanoglu@yahoo.com.
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Tanoglu
authors.affiliation: GATA Ankara Training Hospital, Gastroenterology Department, 06034 Ankara, Turkey. Electronic address: serdarsakin78@yahoo.com.
authors.forename: Yusuf Serdar
authors.initials: YS
authors.lastname: Sakin
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: tanerakyol73@hotmail.com.
authors.forename: Taner
authors.initials: T
authors.lastname: Akyol
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: koncu971@hotmail.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Oncu
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: drmuammerkara70@hotmail.com.
authors.forename: Muammer
authors.initials: M
authors.lastname: Kara
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: yusufyazgan@gmail.com.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yazgan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D061827:Dimensional Measurement Accuracy; D015154:Esophageal Motility Disorders / Q000175:diagnosis*; D004941:Esophagitis / Q000175:diagnosis; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D005756:Gastritis / Q000175:diagnosis; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Gastrooesophageal reflux symptoms; Landmark; Oesophagogastric junction; Upper gastrointestinal endoscopy