Endoscopy is a visual exploration technique that allows for the diagnosis, treatment, and monitoring of a wide range of gastrointestinal conditions. The quality of endoscopic procedures is essential to ensure patient safety, comfort, and diagnostic accuracy. However, despite strict protocols, variations in examination quality may still occur.

The aim of our study was to analyze quality criteria in digestive endoscopy based on retrospective data and to identify areas for improvement in clinical practice.

This is a retrospective, descriptive study conducted over one year, from January 2024 to January 2025, within the endoscopy unit of our department. All patients who underwent an esophagogastroduodenoscopy (EGD) or a total ileocolonoscopy during this period were included. We collected epidemiological data, indications for endoscopy, as well as information on tolerance, quality of visualization, completeness of the procedure, and complications. For EGD, procedural completeness was defined as visualization of the second portion of the duodenum (D2). For colonoscopy, completeness was defined as intubation of the cecal pole. Quality of preparation was assessed through the visualization of the gastric mucosa for EGD and using the Boston Bowel Preparation Scale for total ileocolonoscopy.

A total of 330 endoscopic procedures were performed during the study period, including 199 esophagogastroduodenoscopies (EGD) and 131 total ileocolonoscopies. Among the patients undergoing EGD, women were slightly predominant (56.3%), with a mean age of 47.9 years. The most common indication was anemia (10.05%), followed by upper and lower gastrointestinal bleeding, epigastric pain, vomiting, and dysphagia. Nearly all patients (95%) benefited from a pre-anesthesia consultation, while 5% underwent the examination without sedation. Overall tolerance was good in 96% of cases, with only 3.5% showing intolerance related mainly to desaturation or difficulties with the unsedated procedure. Visualization of the gastric mucosa was satisfactory in 93.5% of EGD examinations, while limitations were mostly due to non-aspirable food debris, esophageal strictures, or significant gastric stasis. The procedure was complete—with successful progression to the second portion of the duodenum—in 91.5% of patients. Incomplete examinations (8.5%) were mainly due to solid food residue, non-passable esophageal stenosis, gastric stasis, or early termination caused by intolerance. No major complications occurred, aside from a few cases of desaturation and intolerance to unsedated endoscopy. Among the 131 ileocolonoscopies, there was a female predominance with 73 women (55.7%) and 58 men (44.3%) (sex ratio 1.25). The mean age was 47.6 years (16–86). The main indications were rectal bleeding in 26 cases (19.84%), IBD-related evaluation colonoscopies in 25 cases (19.08%), bowel habit disorders in 22 cases (16.79%), and chronic abdominal pain in 16 cases (12.21%). Most procedures were performed under anesthesia (126 patients, 96.2%), while 5 (3.8%) were unsedated. Tolerance was good in 129 patients (98.5%), whereas 2 unsedated patients (1.5%) did not tolerate the procedure. Bowel preparation quality (Boston Scale) showed: 9 patients (6.9%) with a score of 0 requiring rescheduling; 9 (6.9%) with a score of 4; 35 (26.7%) with 5; 32 (24.4%) with 6; 21 (16%) with 7; 21 (16%) with 8; and 4 (3.1%) with a score of 9. Cecal intubation was achieved in 87 cases (66.41%), including 74 with terminal ileum (TI) intubation and 13 without. Completion was not possible in 44 cases (33.58%): 29 due to poor preparation, 14 due to stenosis, and 1 due to high perforation risk. No complications were reported.

Endoscopy is an essential technique for the diagnosis and management of many gastrointestinal diseases, but ensuring high-quality examinations remains a major challenge to guarantee patient safety and continuously improve medical practice. Our study showed that the majority of endoscopic procedures achieved good quality in terms of diagnostic precision and safety. However, improvements are still needed, particularly regarding unsedated procedures and patient education on optimal preparation, to ensure the best possible outcomes.