Therapeutic endoscopy practice at a resource-limited setup: experience from a GI center in Addis Ababa, Ethiopia

Background: Endoscopic evaluation has a diagnostic and therapeutic component. With the advent of technology, many gastrointestinal problems requiring surgical intervention can now be managed endoscopically. In most resource-limited setups the practice of therapeutic endoscopy is scarce and services usually provide diagnostic endoscopic examination only. Methods: An 8-year retrospective study was done to assess the pattern and practice of therapeutic endoscopy in patients who underwent therapeutic endoscopic procedures at Adera Medical Center, Addis Ababa, Ethiopia. The socioeconomic, clinical, and endoscopic data of the patients were collected and analyzed. Results: During the study period, a total of 27,283 endoscopies and colonoscopies were performed at the center, of whom 1769 patients had therapeutic procedures. The mean age of the patients was 40.95(15.5), and the majority (75.2%) of the patients were males. Therapeutic procedures included esophageal variceal ligation (69.2%), sclerotherapy (8.5 %), polypectomy (6.8%), hemorrhoid banding (5.8%), achalasia and stricture dilatation (7.1%), endoscopic foreign body removal (1.7%), adrenaline injection (0.7%), and hemoclip application (0.1%). Immediate hemostasis was achieved through endoscopic intervention in all patients that presented with upper gastrointestinal bleeding. Achalasia and stricture dilatations were done with immediate post-procedural symptomatic relief in 100% and 95.56% of the patients, respectively. 96.67% of the patients with GIT foreign body impaction and patients with polyps were treated endoscopically without the need for surgical intervention. Conclusion: In a resource-limited setup like Ethiopia, the provision of therapeutic endoscopic services can help in the management of a variety of gastrointestinal problems. Efforts geared towards the provision of therapeutic endoscopic services help alleviate multitudes of life-threatening problems as evidenced in this study.