Analysis of influencing factors and strategy optimization for visualization of the esophagogastric junction during gastroscopy

LIU Nai-ting; YU Bo; PU Xiao-lin

doi:10.11659/jjssx.01E026011

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Analysis of influencing factors and strategy optimization for visualization of the esophagogastric junction during gastroscopy

Clinical Research | 更新时间：2026-10-26

- Analysis of influencing factors and strategy optimization for visualization of the esophagogastric junction during gastroscopy
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 10, Pages: 914-918(2026)
- 作者机构：
  
  哈尔滨市第二医院消化内科，黑龙江哈尔滨 150000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E026011
  CLC： R573;R57
- Received：05 January 2026，
  
  Revised：2026-09-23，
  
  Accepted：14 April 2026，
  
  Published：25 October 2026
- 稿件说明：
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刘乃婷,于波,蒲肖琳.胃镜检查中食管胃连接部可视化程度的影响因素分析及策略优化[J].局解手术学杂志,2026,35(10):914-918.

LIU Nai-ting,YU Bo,PU Xiao-lin.Analysis of influencing factors and strategy optimization for visualization of the esophagogastric junction during gastroscopy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):914-918.
刘乃婷,于波,蒲肖琳.胃镜检查中食管胃连接部可视化程度的影响因素分析及策略优化[J].局解手术学杂志,2026,35(10):914-918. DOI： 10.11659/jjssx.01E026011.

LIU Nai-ting,YU Bo,PU Xiao-lin.Analysis of influencing factors and strategy optimization for visualization of the esophagogastric junction during gastroscopy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):914-918. DOI： 10.11659/jjssx.01E026011.

摘要

目的

系统分析影响胃镜下食管胃连接部（EGJ）可视化程度的关键因素，并基于分析结果构建一套优化的临床检查策略。

方法

回顾性分析2024年8月至2025年7月于我院行诊断性胃镜检查的625例患者的临床资料。采用自创的四分法独立评估EGJ可视化程度。根据胃镜下EGJ可视化程度，将患者分为充分可视化组（403例）和可视化不良组（222例）。采用单因素及多因素Logistic回归分析影响EGJ充分可视化的独立因素。

结果

单因素分析结果显示，2组实施镇静、使用解痉剂、胃食管瓣阀（GEFV）Ⅲ/Ⅳ级、反流性食管炎及食管裂孔疝的患者比例存在统计学差异（

0.05）。多因素Logistic分析结果显示，使用解痉剂（

=0.43

95%

: 0.27~0.68

0.001）、较高的GEFV分级（

=0.29

95%

: 0.13~0.64

=0.002）和存在反流性食管炎（

=0.61

95%

: 0.38~0.99

=0.045）是EGJ充分可视化的独立保护因素，而实施镇静麻醉（

=2.91

95%

: 2.01~4.21

0.001）是EGJ充分可视化的独立危险因素。

结论

实施镇静是EGJ充分可视化的独立危险因素，而术前使用解痉剂、GEFV Ⅲ/Ⅳ级和存在反流性食管炎是EGJ充分可视化的独立保护因素。GEFV分级和反流性食管炎可作为预判EGJ暴露难易度的内镜参考指标。基于上述影响因素构建的EGJ检查优化临床决策路径，整合术前评估、药理学干预及技术辅助，可能有助于改善EGJ可视化质量，但其对病变检出率的实际影响尚需前瞻性研究验证。

Abstract

Objective

To systematically analyze the key factors influencing the visualization quality of the esophagogastric junction （EGJ）during gastroscopy and to develop an optimized clinical examination strategy based on the analysis results.

Methods

The clinical data of 625 patients who underwent diagnostic gastroscopy at our hospital from August 2024 to July 2025 were retrospectively analyzed. The visualization quality of EGJ was independently assessed by a self‑developed four‑point scale. Based on the visualization quality of EGJ under gastroscopy， patients were divided into the adequate visualization group （403 cases） and the poor visualization group （222 cases）. Univariate and multivariate Logistic regression analyses were performed to identify independent factors affecting adequate EGJ visualization.

Results

Univariate analysis showed that there were statistically significant differences between the two groups in the proportions of patients with sedation，antispasmodic administration， gas

troesophageal flap valve （GEFV） grade Ⅲ/Ⅳ，reflux esophagitis，and hiatal hernia （

0.05）.Multivariate Logistic

regression analysis revealed that antispasmodic administration（

=0.43，95%

：0.27 to 0.68，

0.001）， higher GEFV grade （

=0.29，95%

：0.13 to 0.64，

=0.002）， and the presence of reflux esophagitis （

=0.61， 95%

： 0.38 to 0.99，

=0.045） were the independent protective factors for adequate EGJ visualization， whereas the administration of sedation anesthesia（

=2.91， 95%

： 2.01 to 4.21，

0.001） was the independent risk factor for adequate EGJ visualization.

Conclusion

Administration of sedation is an independent risk factor for adequate EGJ visualization， whereas antispasmodic administration， higher GEFV grade （Ⅲ/Ⅳ）， and the presence of reflux esophagitis are the independent protective factors for adequate EGJ visualization. GEFV grade and reflux esophagitis may serve as endoscopic reference indicators for predicting the difficulty of EGJ exposure. The optimized clinical decision‑making pathway for EGJ examination constructed based on the above factors integrates preoperative assessment， pharmacological intervention，and technical assistance，which may help improve the visualization quality of EGJ.However，its actual impact on lesion detection rate still requires validation in prospective studies.

关键词

Keywords

references

Sung H ， Ferlay J ， Siegel RL ， et al . Global cancer statistics 2020：GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries ［J］. CA Cancer J Clin ， 2021 ， 71 （ 3 ）： 209 - 249 . doi： 10.3322/caac.21660 http://dx.doi.org/10.3322/caac.21660 .

Pasta A ， Calabrese F ， Furnari M ， et al . Endoscopic management of eosinophilic esophagitis：a narrative review on diagnosis and treatment ［J］. J Clin Med ， 2025 ， 14 （ 11 ）： 3756 . doi： 10.3390/jcm14113756 http://dx.doi.org/10.3390/jcm14113756 .

Inoue M ， Ragunath K . Quality indicators in Barrett's endoscopy：best is yet to come ［J］. Dig Endosc ， 2024 ， 36 （ 3 ）： 265 - 273 . doi： 10.1111/den.14654 http://dx.doi.org/10.1111/den.14654 .

Morita A ， Nakayama Y ， Horiuchi A ， et al . Stimulating peristalsis improves esophagogastric junction observation during sedated esophagogastroduodenoscopy in children and adolescents ［J］. Acta Gastroenterol Belg ， 2022 ， 85 （ 1 ）： 15 - 19 . doi： 10.51821/85.1.9240 http://dx.doi.org/10.51821/85.1.9240 .

Chen Z ， Liu L ， Tu J ， et al . Improvement of atropine on esophagogastric junction observation during sedative esophagogastroduodenoscopy ［J］. PLoS One ， 2017 ， 12 （ 6 ）： e0179490 . doi： 10.1371/journal.pone.017 9490 http://dx.doi.org/10.1371/journal.pone.0179490 .

André T ， Tougeron D ， Piessen G ， et al . Neoadjuvant nivolumab plus ipilimumab and adjuvant nivolumab in localized deficient mismatch repair/microsatellite instability-high gastric or esophagogastric junction adenocarcinoma：the GERCOR NEONIPIGA phase II study ［J］. J Clin Oncol ， 2023 ， 41 （ 2 ）： 255 - 265 . doi： 10.1200/JCO.22.00686 http://dx.doi.org/10.1200/JCO.22.00686 .

郭天宇，胡雪，尹静一，等 . 胃镜检查中影响食管胃连接部可视化程度的相关因素分析［J］. 安徽医药， 2025 ， 29 （ 11 ）： 2228 - 2231 . doi： 10.3969/j.issn.1009-6469.2025.11.023 http://dx.doi.org/10.3969/j.issn.1009-6469.2025.11.023 .

Hill LD ， Kozarek RA ， Kraemer SJ ， et al . The gastroesophageal flap valve：in vitro and in vivo observations ［J］. Gastrointest Endosc ， 1996 ， 44 （ 5 ）： 541 - 547 . doi： 10.1016/s0016-5107（96）70006-8 http://dx.doi.org/10.1016/s0016-5107（96）70006-8

Lundell LR ， Dent J ， Bennett JR ， et al . Endoscopic assessment of oesophagitis：clinical and functional correlates and further validation of the Los Angeles classification ［J］. Gut ， 1999 ， 45 （ 2 ）： 172 - 180 . doi： 10.1136/gut.45.2.172 http://dx.doi.org/10.1136/gut.45.2.172

Kim B ， Lee HJ ， Kim DW ， et al . Does sedation affect examination of the esophagogastric junction during upper endoscopy？［J］. Yonsei Med J ， 2015 ， 56 （ 6 ）： 1566 - 1571 . doi： 10.3349/ymj.2015.56.6. 1566 http://dx.doi.org/10.3349/ymj.2015.56.6.1566 .

Bertin L ， Savarino V ， Marabotto E ， et al . Pathophysiology of gastroesophageal reflux disease ［J］. Digestion ， 2026 ， 107 （ 2 ）： 185 - 201 . doi： 10.1159/000547023 http://dx.doi.org/10.1159/000547023 .

Liu Y ， Gu K . Association between anesthesia assistance and precancerous lesions and early cancer detection during diagnostic esophagogastroduodenoscopy：a propensity score-matched retrospective study ［J］. Front Med （Lausanne）， 2024 ， 11 ： 1389809 . doi： 10.3389/fmed.2024.1389809 http://dx.doi.org/10.3389/fmed.2024.1389809 .

刘畅，孙雨萌，郝欣，等 . 蓝激光成像技术联合放大内镜与白光内镜诊断食管胃连接部病变的价值［J］. 中国内镜杂志， 2025 ， 31 （ 1 ）： 32 - 39 . doi： 10.12235/E20240277 http://dx.doi.org/10.12235/E20240277 .

Rex DK ， Anderson JC ， Butterly LF ， et al . Quality indicators for colonoscopy ［J］. Gastrointest Endosc ， 2024 ， 100 （ 3 ）： 352 - 381 . doi： 10.1016/j.gie.2024.04.2905 http://dx.doi.org/10.1016/j.gie.2024.04.2905 .

Miyaoka M ， Yao K ， Tanabe H ， et al . Diagnosis of early gastric cancer using image enhanced endoscopy：a systematic approach ［J］. Transl Gastroenterol Hepatol ， 2020 ， 5 ： 50 . doi： 10.21037/tgh.2019.12.16 http://dx.doi.org/10.21037/tgh.2019.12.16 .

Wang P ， Berzin TM ， Glissen Brown JR ， et al . Real-time automatic detection system increases colonoscopic polyp and adenoma detection rates：a prospective randomised controlled study ［J］. Gut ， 2019 ， 68 （ 10 ）： 1813 - 1819 . doi： 10.1136/gutjnl-2018-317500 http://dx.doi.org/10.1136/gutjnl-2018-317500 .

Farah A ， Abboud W ， Shibli F ， et al . Preoperative gastroenterological evaluation for anti-reflux surgery：strengthening surgeon-gastroenterologist collaboration and improving patient selection ［J］. Expert Rev Gastroenterol Hepatol ， 2025 ， 19 （ 9 ）： 963 - 972 . doi： 10.1080/17474124.2025.2549377 http://dx.doi.org/10.1080/17474124.2025.2549377 .

di Pietro M ， Fitzgerald RC . BSG Barrett's guidelines working group.Revised British Society of Gastroenterology recommendation on the diagnosis and management of Barrett's oesophagus with low-grade dysplasia ［J］. Gut ， 2018 ， 67 （ 2 ）： 392 - 393 . doi： 10.1136/gutjnl-2017-314135 http://dx.doi.org/10.1136/gutjnl-2017-314135 .

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