Prevalence Of Endoscopy Related Injuries and Its Impact on Clinical Practice: A Systematic Review and Meta-Analysis

BACKGROUND: Endoscopy related musculoskeletal injuries (ERI) are commonly reported but its exact prevalence and clinical impact remains obscure. We conducted a systematic review and meta-analysis of the present literature to answer these questions. METHODS: MEDLINE, Embase and Scopus databases were searched for studies evaluating ERI in gastroenterologists, and surgeons. The co-primary outcome was to assess prevalence of endoscopy related injuries ie. Carpal tunnel syndrome (CTS), De Quervain's tenosynovitis (DQTS) and hand numbness. The other co-primary outcome was to assess prevalence of endoscopy related pain syndromes in the present literature. RESULTS: Twelve studies including 4563 respondents were included. Majority of the participants were males (3321, 72.7%) and most were right-handed (86.2%). The career prevalence of CTS as pooled from ten studies was 5.3% (95% CI: 1.5%, 8.9%, I²=97.1%), while prevalence of DQTS as reported by five studies was 8.5% (95% CI 0.1%, 17.0%). The pooled prevalence of thumb pain, neck pain and back pain was 25.4%, 23.1% and 19.7% respectively but the prevalence varied according to the type of questionnaires used. Only 341 of 864 (39.4%) respondents had received prior training in ergonomics while 623 of 889 (69.0%) respondents expressed a desire for further training in ergonomics. Overall, there is a moderate risk of bias in the present literature. CONCLUSION: Endoscopy related injuries of CTS, DQTS and endoscopy related pain are very common. These injuries can be severe, requiring surgery, and lead to loss of productivity. Most gastroenterologist report an unmet need for training in proper ergonomics of endoscopy.